Individual provider Active NPI

Lyba Khan, PA

  • Physician Assistant
  • Leesburg, VA
National Provider Identifier
1386454874
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110011603 Issued in VA
Practice address
540 Fort Evans Rd
Leesburg, VA 20176-3382
Phone
(703) 737-3500
NPI assigned
Jan 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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 0110011603 VA Primary

Addresses

Primary practice location

540 Fort Evans Rd
Leesburg, VA 20176-3382

Mailing address

540 Fort Evans Rd
Leesburg, VA 20176-3382
Phone (703) 737-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110011603VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Family Medicine and Medspa LLC CurrentSince Jun 23, 2026 Accepting new patients

Locations

540 Fort Evans Rd
Ste 204
Leesburg, VA 20176
Phone (703) 737-3500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGCHAD/Endpoint/IGCHAD

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": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1386454874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 FORT EVANS RD",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763382",
            "telephone_number": "703-737-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 FORT EVANS RD",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763382",
            "telephone_number": "703-737-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "LYBA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.