Individual provider Active NPI

Catherine Jonnakuty Ellis, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Leesburg, VA
National Provider Identifier
1548473150
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101259955 Issued in VA
Practice address
19450 Deerfield Avenue, Suite 200
Leesburg, VA 20176-6821
Phone
(703) 844-8380
Fax
(703) 263-8393
NPI assigned
May 8, 2007
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MT189022 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101259955 VA Primary

Addresses

Primary practice location

19450 Deerfield Avenue, Suite 200
Leesburg, VA 20176-6821

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
30015941210002MedicaidVA
1548473150MedicaidVA

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
I20160613000814 DC Practitioner - Endocrinology 2365516333 Reassigns benefits to 1 organization
I20211008000015 VA Practitioner - Endocrinology 2365516333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2001
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

Practice addresses (Care Compare)

19450 Deerfield Ave
Suite 200
Leesburg, VA 20176-6821
Phone (703) 844-8380

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT189022PAMDEndocrinology, Diabetes & Metabolism Physician
0101259955VAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Endocrinology, Diabetes & Metabolism CurrentSince May 23, 2016 Accepting new patients
Loudoun Medical Group, PC CurrentSince Nov 1, 2021 Accepting new patients
Loudoun Medical Group, PC CurrentSince Nov 1, 2021 Accepting new patients
Privia Medical Group, LLC CurrentSince May 23, 2016 Accepting new patients
Endocrinology Consultants, P.C. Endocrinology, Diabetes & Metabolism PastSince Jul 1, 2010 Accepting new patients
Hand Therapy Center, LLC Past Accepting new patients

Locations

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

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

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

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

19450 Deerfield Ave
Ste 300
Leesburg, VA 20176
Phone (703) 723-6774

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

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

Interoperability endpoints

  • Direct secure messaging: catherine.ellis@lmg1.eclinicaldirectplus.com

Organizations & group practices 6

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 2

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1548473150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "571-291-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVENUE, SUITE 200",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766821",
            "telephone_number": "703-844-8380",
            "fax_number": "703-263-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CATHERINE",
        "middle_name": "JONNAKUTY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MT189022",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101259955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015941210002",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548473150",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.