Individual provider Active NPI

Samantha Leahy, PA

  • Surgical Physician Assistant
  • Fairfax, VA
National Provider Identifier
1427593086
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110005629 Issued in VA
Practice address
3023 Hamaker CT Ste 500
Fairfax, VA 22031-2241
Phone
(703) 876-2788
NPI assigned
Jan 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110005629 VA Primary
Physician Assistant 363A00000X 0110005629 VA

Addresses

Primary practice location

3023 Hamaker CT Ste 500
Fairfax, VA 22031-2241

Mailing address

4113 Duncan Dr
Annandale, VA 22003-3704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20170214002512 DC Practitioner - Physician Assistant 2668755885 Reassigns benefits to 2 organizations
I20170707002244 VA Practitioner - Physician Assistant 2668755885 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110005629VAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jan 1, 2024 Accepting new patients
Inova Health Care Services Past Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: sleahy246083@soc.inova.org

Organizations & group practices 4

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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1427593086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 DUNCAN DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT STE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312241",
            "telephone_number": "703-876-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "SAMANTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110005629",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.