Individual provider Active NPI

Melissa Johnson Antonik, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Leesburg, VA
National Provider Identifier
1316025372
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101245254 Issued in VA
Practice address
19500 Sandridge Way Ste 180
Leesburg, VA 20176-3692
Phone
(703) 673-0171
Fax
(703) 673-0178
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101245254 VA Primary

Addresses

Primary practice location

19500 Sandridge Way Ste 180
Leesburg, VA 20176-3692

Mailing address

19500 Sandridge Way Ste 180
Leesburg, VA 20176-3692
Phone (703) 673-0171

Other names 1

  • Ms. Melissa Anne Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110623000737 DC Practitioner - Endocrinology 2365547148 Reassigns benefits to 1 organization
I20140625002126 VA Practitioner - Endocrinology 2365547148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Georgetown University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101245254VAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Endocrinology, Diabetes & Metabolism CurrentSince Nov 30, 2013 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 30, 2013 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

3201 Jermantown Rd
Ste 250
Fairfax, VA 22030
Phone (703) 849-8440

3020 Hamaker Ct
Ste 502
Fairfax, VA 22031
Phone (703) 849-8440

19500 Sandridge Way
Ste 180
Leesburg, VA 20176
Phone (703) 673-0171

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melissa.antonik.2@8042.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1316025372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 180",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763692",
            "telephone_number": "703-673-0171",
            "fax_number": "703-673-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 180",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763692",
            "telephone_number": "703-673-0171",
            "fax_number": "703-673-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIK",
        "first_name": "MELISSA",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101245254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "JOHNSON",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.