Individual provider Active NPI

Amanda Elizabeth Smart

  • Urology Physician
  • Leesburg, VA
National Provider Identifier
1528520681
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101279969 Issued in VA
Practice address
19415 Deerfield Avenue, Suite 112
Leesburg, VA 20176-8470
Phone
(703) 724-1195
Fax
(703) 724-4495
NPI assigned
Apr 5, 2019
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Urology Physician 208800000X 0101279969 VA Primary

Addresses

Primary practice location

19415 Deerfield Avenue, Suite 112
Leesburg, VA 20176-8470

Mailing address

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

Other practice location 1

1860 Town Center Drive, Suite 150
Reston, VA 20190-5905
Phone (703) 480-0220

Other practice location 2

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-3000

Other identifiers 1

IdentifierTypeStateIssuer
30018093910001MedicaidVA

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241203002700 DC Practitioner - Urology 5395270177 Reassigns benefits to 2 organizations
I20250103000729 VA Practitioner - Urology 5395270177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Georgetown University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians
Gastrointestinal Specialists LLCGroup PAC ID 5294797957, 79 clinicians

Practice addresses (Care Compare)

1860 Town Ctr Dr
Suite 150
Reston, VA 20190-5905
Phone (703) 480-0220

19415 Deerfield Ave
Suite 112
Leesburg, VA 20176-8470
Phone (703) 724-1195

224 D Cornwall St NW
Suite 400
Leesburg, VA 20176-2704
Phone (703) 443-6733

24430 Stone Springs Blvd
Suite 525
Dulles, VA 20166-2267
Phone (703) 957-1022

6602 W Broad St
Suite B
Richmond, VA 23230-1702
Phone (804) 285-8206

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101279969VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Specialists LLC Urology CurrentSince Feb 1, 2026 Accepting new patients
Loudoun Medical Group, PC Current Accepting new patients
Loudoun Medical Group, PC CurrentSince Jan 6, 2025 Accepting new patients
Loudoun Medical Group, PC Urology CurrentSince Jan 6, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

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

24430 Stone Springs Blvd
Ste 545
Dulles, VA 20166
Phone (703) 957-1022

19415 Deerfield Ave
Ste 112
Leesburg, VA 20176
Phone (703) 724-1195

224D Cornwall St NW
Ste 400
Leesburg, VA 20176
Phone (703) 443-6733

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

1860 Town Center Dr
Ste 150
Reston, VA 20190
Phone (703) 480-0220

6602 W Broad St
#B
Richmond, VA 23230
Phone (804) 289-1137

24430 Stone Springs Blvd
Ste 100
Sterling, VA 20166
Phone (703) 723-6774

Interoperability endpoints

  • Direct secure messaging: amanda.smart@lmg1.eclinicaldirectplus.com
  • Direct secure messaging: asmart19922@gwmfa.direct-ci.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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1528520681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVENUE, SUITE 112",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768470",
            "telephone_number": "703-724-1195",
            "fax_number": "703-724-4495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Town Center Drive, Suite 150",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "201905905",
            "country_code": "US",
            "telephone_number": "703-480-0220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 Pennsylvania Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMART",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101279969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30018093910001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.