Individual provider Active NPI

Stephanie L Modzelesky, PA-C

  • Physician Assistant
  • Leesburg, VA
National Provider Identifier
1417919408
Registry record updated Feb 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002171 Issued in VA
Practice address
19450 Deerfield Ave Ste 200
Leesburg, VA 20176-6821
Phone
(571) 209-1875
Fax
(703) 777-3365
NPI assigned
Apr 5, 2006
Last updated
Feb 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2026

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 0110002171 VA Primary
Surgical Physician Assistant 363AS0400X 0110002171 VA

Addresses

Primary practice location

19450 Deerfield Ave Ste 200
Leesburg, VA 20176-6821

Mailing address

224-D Cornwall St., NW, Suite 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 3

IdentifierTypeStateIssuer
0110002171OtherVALICENSE
1417919408MedicaidVA
30015904250001MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephanie.modzelesky.p1@direct.tsiva.nextgenshare.com Health Information Exchange (HIE) ARTHRITIS & SPORTS ORTHOPAEDICS PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, MD3 enrollments
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.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070501000288 VA Practitioner - Physician Assistant 8224056056 Reassigns benefits to 2 organizations
I20070907000412 DC Practitioner - Physician Assistant 8224056056 Reassigns benefits to 2 organizations
I20211202001345 MD Practitioner - Physician Assistant 8224056056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

1901 Lockhouse Dr
Point of Rocks, MD 21777-2104
Phone (301) 874-2211

19450 Deerfield Ave
Leesburg, VA 20176-6821

20955 Professional PLZ
Suite 200
Ashburn, VA 20147-3405
Phone (703) 729-7652

224 D Cornwall St NW
Leesburg, VA 20176-2700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002171VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Dec 13, 2021 Accepting new patients
Loudoun Medical Group, PC CurrentSince Dec 13, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

6000 Executive Blvd
Ste 604
North Bethesda, MD 20852

1901 Lockhouse Dr
Point of Rocks, MD 21777
Phone (301) 874-2211

6355 Walker Ln
Ste 308
Alexandria, VA 22310
Phone (703) 313-7700

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

19441 Golf Vista Plz
Ste 230
Leesburg, VA 20176
Phone (703) 724-7474

19450 Deerfield Ave
Ste 200
Leesburg, VA 20176
Phone (703) 723-7337

224D Cornwall St NW
Ste 204
Leesburg, VA 20176
Phone (571) 209-1875

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

44055 Riverside Pkwy
Ste 208
Leesburg, VA 20176
Phone (703) 729-7652

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Interoperability endpoints

  • Direct secure messaging: stephanie.modzelesky@lmg1.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770422400000",
    "number": "1417919408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL ST., NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVE STE 200",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766821",
            "telephone_number": "571-209-1875",
            "fax_number": "703-777-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODZELESKY",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002171",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0110002171",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417919408",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015904250001",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.modzelesky.p1@direct.tsiva.nextgenshare.com",
            "affiliation": "Y",
            "endpointDescription": "Nextgen email address",
            "affiliationName": "ARTHRITIS & SPORTS ORTHOPAEDICS PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "21475 Ridgetop Cir",
            "address_2": "Suite 150",
            "city": "Sterling",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201666580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.