Individual provider Active NPI

Deborah I Leavens, MD

  • Family Medicine Physician
  • Herndon, VA
National Provider Identifier
1407840788
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101032359 Issued in VA
Practice address
555 Herndon Pkwy
Ste 100
Herndon, VA 20170-5276
Phone
(703) 481-1505
Fax
(703) 742-8793
NPI assigned
Sep 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101032359 VA Primary

Addresses

Primary practice location

555 Herndon Pkwy
Ste 100
Herndon, VA 20170-5276

Mailing address

555 Herndon Pkwy
Ste 100
Herndon, VA 20170-5276
Phone (703) 481-1505

Other identifiers 2

IdentifierTypeStateIssuer
080182909OtherVARR MEDICARE
05622581MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dleavens25589@soc.inova.org Health Information Exchange (HIE) Inova Physician Partners, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000435 DC Practitioner - Family PracticePractitioner - Geriatric Medicine 2769381714 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Virginia Commonwealth University, School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

381 Elden St
Suite 1000
Herndon, VA 20170-4842
Phone (703) 481-1505

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jun 25, 2020 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Jun 24, 2015 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 24, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients
Icardio Corporation a Medical Corporation PastSince Jul 1, 2001 Accepting new patients

Locations

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

6201 Centreville Rd
Ste 100
Centreville, VA 20121
Phone (703) 263-9600

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

381 Elden St
Ste 1000
Herndon, VA 20170
Phone (703) 481-1505

555 Herndon Pkwy
Ste 100
Herndon, VA 20170
Phone (703) 481-1505

115 Park St SE
Ste 300
Vienna, VA 22180
Phone (703) 255-9100

Interoperability endpoints

  • Direct secure messaging: dleavens25589@soc.inova.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1407840788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 HERNDON PKWY",
            "address_2": "STE 100",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705276",
            "telephone_number": "703-481-1505",
            "fax_number": "703-742-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 HERNDON PKWY",
            "address_2": "STE 100",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705276",
            "telephone_number": "703-481-1505",
            "fax_number": "703-742-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVENS",
        "first_name": "DEBORAH",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080182909",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05622581",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dleavens25589@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Exchange Information",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "381 Elden St Ste 1000",
            "city": "Herndon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201704842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.