NPIMap

Individual provider Active NPI

Olivia Cynthia Ambursley-Gries

  • Physician Assistant
  • Largo, MD
National Provider Identifier
1376359190
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C09742 Issued in MD
Practice address
901 Harry S Truman Dr N
Largo, MD 20774-5477
Phone
(240) 677-1000
NPI assigned
Dec 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C09742 MD Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

901 Harry S Truman Dr N
Largo, MD 20774-5477

Mailing address

2130 P St NW Apt 206
Washington, DC 20037-1071
Phone (517) 648-7688

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250408002990 DC Practitioner - Physician Assistant 8123542446 Reassigns benefits to 2 organizations
I20260327001345 VA Practitioner - Physician Assistant 8123542446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dimensions Healthcare Associates, IncGroup PAC ID 1557269743, 198 clinicians
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2900 Mercy LN
Cheverly, MD 20785-1157
Phone (301) 618-2273

3300 Gallows Rd
Falls Church, VA 22042-3307

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 771-2960

901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477
Phone (240) 677-3000

Hospital & facility affiliations

  • University of MD Capital Region Medical Center Hospital, Upper Marlboro, MD, CCN 210003
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C09742MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Feb 16, 2026 Accepting new patients
Dimensions Healthcare Associates Inc CurrentSince Feb 3, 2025 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Feb 3, 2025 Accepting new patients
Inova Health Care Services CurrentSince Feb 16, 2026 Accepting new patients

Locations

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Interoperability endpoints

  • Direct secure messaging: oambursleygries1240420@direct.umm.edu

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 3

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": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1376359190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 P ST NW APT 206",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371071",
            "telephone_number": "517-648-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-677-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBURSLEY-GRIES",
        "first_name": "OLIVIA",
        "middle_name": "CYNTHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C09742",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.