NPIMap

Organization Active NPI

Loudoun Medical Group, PC

Doing business as DME

  • Podiatrist
  • Leesburg, VA
National Provider Identifier
1336816818
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Doing business as
DME
Practice address
19450 Deerfield Avenue, Suite 200
Leesburg, VA 20176-6821
Phone
(703) 737-6001
NPI assigned
Aug 24, 2021
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LOUDOUN MEDICAL GROUP. PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Mary Beth Tamasy
Title
Ceo
Phone
(703) 737-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

19450 Deerfield Avenue, Suite 200
Leesburg, VA 20176-6821

Mailing address

224D Cornwall St NW Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6001

Other names 1

  • DME Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210920001038 VA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0042119661 Practice locations: Leesburg, VA

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
John M Archer MD305 organizations share this tax ID, including this one
Part of
John M Archer MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1336816818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVENUE, SUITE 200",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766821",
            "telephone_number": "703-737-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP. PC",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "TAMASY",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-737-6001"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.