Individual provider Active NPI

Eric Zelsdorf, PSYD

  • Clinical Psychologist
  • Leesburg, VA
National Provider Identifier
1255765293
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810005246 Issued in VA
Practice address
217 S King St
Leesburg, VA 20175-2905
Phone
(703) 464-7400
Fax
(703) 777-0170
NPI assigned
Aug 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810005246 VA Primary
Clinical Neuropsychologist 103G00000X 0810005246 VA

Addresses

Primary practice location

217 S King St
Leesburg, VA 20175-2905

Mailing address

217 S King St
Leesburg, VA 20175-2905
Phone (703) 464-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223001799 VA Practitioner - Clinical Psychologist 0648575043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

217 S King St
Leeesburg, VA 20175-2905
Phone (703) 297-4368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810005246VAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Psychological Services, LLC Psychologist CurrentSince Dec 28, 2015 Accepting new patients

Locations

217 S King St
Leesburg, VA 20175
Phone (703) 297-4368

107 Carpenter Dr
Ste 110
Sterling, VA 20164
Phone (703) 297-4368

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1255765293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S KING ST",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201752905",
            "telephone_number": "703-464-7400",
            "fax_number": "703-777-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S KING ST",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201752905",
            "telephone_number": "703-464-7400",
            "fax_number": "703-777-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELSDORF",
        "first_name": "ERIC",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005246",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810005246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.