Individual provider Active NPI

Stephanie Anne Sanderson, PA-C

  • Physician Assistant
  • Lansdowne, VA
National Provider Identifier
1275852071
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003246 Issued in VA
Practice address
19500 Sandridge Way Ste 100
Lansdowne, VA 20176-3689
Phone
(703) 738-4344
Fax
(703) 642-1876
NPI assigned
May 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003246 VA Primary

Addresses

Primary practice location

19500 Sandridge Way Ste 100
Lansdowne, VA 20176-3689

Mailing address

11350 McCormick Road
Executive Plaza 1, Suite 501
Hunt Valley, MD 21031
Phone (410) 329-1071

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephaniesanderson@nspc.medalliesdirect.net

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013000666 VA Practitioner - Physician Assistant 3779892849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine Associates LTDGroup PAC ID 4981688835, 73 clinicians

Practice addresses (Care Compare)

14605 Potomac Branch Dr
Suite 100
Woodbridge, VA 22191-3337
Phone (703) 738-4371

19500 Sandridge Way
Suite 100
Leesburg, VA 20176-3689
Phone (571) 707-3535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110003246VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine Associates, LTD CurrentSince Jun 27, 2025 Accepting new patients
Physical Medicine Associates, LTD CurrentSince Jun 27, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Physical Medicine Associates LTD Past Accepting new patients

Locations

4960 SW 72nd Ave
Ste 405
Miami, FL 33155
Phone (469) 458-9222

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

3620 Joseph Siewick Dr
Ste 410
Fairfax, VA 22033

5213 Hickory Park Dr
Ste B
Glen Allen, VA 23059
Phone (804) 270-7262

19500 Sandridge Way
Ste 100
Leesburg, VA 20176
Phone (571) 707-3535

14605 Potomac Branch Dr
Ste 100
Woodbridge, VA 22191
Phone (703) 738-4371

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1275852071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK ROAD",
            "address_2": "EXECUTIVE PLAZA 1, SUITE 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031",
            "telephone_number": "410-329-1071",
            "fax_number": "410-329-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 100",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763689",
            "telephone_number": "703-738-4344",
            "fax_number": "703-642-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephaniesanderson@nspc.medalliesdirect.net",
            "affiliation": "N",
            "address_1": "19500 Sandridge Way Ste 100",
            "city": "Lansdowne",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201763689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

Verify at the official NPI Registry.