Individual provider Active NPI

Tetyana Chmyrova, AGNP-C

  • Gerontology Nurse Practitioner
  • Leesburg, VA
National Provider Identifier
1457013161
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024182359 Issued in VA
Practice address
19441 Golf Vista PLZ Ste 230
Leesburg, VA 20176-8271
Phone
(703) 729-3420
NPI assigned
Oct 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024182359 VA Primary

Addresses

Primary practice location

19441 Golf Vista PLZ Ste 230
Leesburg, VA 20176-8271

Mailing address

PO Box 3250
Winchester, VA 22604-2450
Phone (703) 673-4490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NJ, VA3 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
I20211215002967 DC Practitioner - Nurse Practitioner 4385035948 Reassigns benefits to 2 organizations
I20230217000032 NJ Practitioner - Nurse Practitioner 4385035948 Reassigns benefits to 1 organization
I20250918001501 VA Practitioner - Nurse Practitioner 4385035948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optimize Medical GroupGroup PAC ID 0446512040, 31 clinicians

Practice addresses (Care Compare)

19441 Golf Vista PLZ
Suite 230
Leesburg, VA 20176-8271
Phone (703) 729-3420

5901 Kingstowne Village Pkwy
Suite 101
Alexandria, VA 22315-5881
Phone (703) 729-3420

8280 Willow Oaks Corporate Dr
Suite 600
Fairfax, VA 22031-4516
Phone (443) 868-7101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Pulmonary Associates, P.a. CurrentSince Feb 6, 2023 Accepting new patients
Comprehensive Sleep Care Center Inc Current Accepting new patients
Comprehensive Sleep Care Center Inc CurrentSince Jul 1, 2025 Accepting new patients
Comprehensive Sleep Care Center, Inc. CurrentSince Jul 1, 2025 Accepting new patients

Locations

6000 Executive Blvd
Ste 604
North Bethesda, MD 20852

459 Jack Martin Blvd
Ste 5
Brick, NJ 08724
Phone (732) 840-4200

27 S Cooks Bridge Rd
Ste 2-10
Jackson, NJ 08527
Phone (732) 341-1380

20 Hospital Dr
Ste 9
Toms River, NJ 08755
Phone (732) 341-1380

5901 Kingstowne Village Pkwy
Ste 101
Alexandria, VA 22315
Phone (703) 778-3774

200 N Glebe Rd
Ste 316
Arlington, VA 22203

4080 Lafayette Center Dr
Ste 170C
Chantilly, VA 20151

3687 Fettler Park Dr
Slp Care
Dumfries, VA 22025

605 Emancipation Hwy
Slp Care
Fredericksburg, VA 22401

19441 Golf Vista Plz
Ste 310
Leesburg, VA 20176

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

9420 Forestwood Ln
Ste 202
Manassas, VA 20110

4897 Prince William Pkwy
Ste 102
Woodbridge, VA 22192

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70885

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.

NPI Registry JSON

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

{
    "created_epoch": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1457013161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3250",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226042450",
            "telephone_number": "703-673-4490",
            "fax_number": "540-678-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19441 GOLF VISTA PLZ STE 230",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768271",
            "telephone_number": "703-729-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMYROVA",
        "first_name": "TETYANA",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024182359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.