Individual provider Active NPI

Grace Mang Yuet Ma, M.D

  • Pediatric Radiology Physician
  • Leesburg, VA
National Provider Identifier
1548520984
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
0101266910 Issued in VA
Practice address
19500 Sandridge Way, Suite 420
Leesburg, VA 20176
Phone
(571) 375-8601
NPI assigned
May 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X MD047380 DC
Pediatric Radiology Physician 2085P0229X 0101266910 VA Primary

Addresses

Primary practice location

19500 Sandridge Way, Suite 420
Leesburg, VA 20176

Mailing address

PO Box 744785
Atlanta, GA 30374-4785
Phone (202) 476-5000

Other practice location 1

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-5000

Other practice location 2

19500 Sandridge Way, Suite 460
leesburg, VA 20176
Phone (571) 206-0767

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
I20190816000761 DC Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 9739316696 Reassigns benefits to 5 organizations
I20230206001644 VA Practitioner - Diagnostic Radiology 9739316696 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MRI of Reston, LPGroup PAC ID 3476544701, 15 clinicians
Reston Radiology Consultants, PCGroup PAC ID 1557436730, 35 clinicians
Loudoun Imaging Center/Ashburn LLCGroup PAC ID 0042371429, 15 clinicians
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians
Fair Oaks Imaging Center PCGroup PAC ID 7113918426, 17 clinicians
Roanoke Imaging LLCGroup PAC ID 9436215662, 18 clinicians

Practice addresses (Care Compare)

1800 Town Ctr Dr
Suite 115
Reston, VA 20190-3237
Phone (703) 478-0922

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (703) 478-0922

20905 Professional PLZ
Suite 100
Ashburn, VA 20147-3409
Phone (571) 223-0230

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

24440 Stone Springs Blvd
Sterling, VA 20166-2247
Phone (703) 726-1201

4001 Fair Ridge Dr
Suite 103
Fairfax, VA 22033-2917
Phone (703) 385-5203

4330 Brambleton Ave
Roanoke, VA 24018-3405
Phone (540) 283-3700

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

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.54 of 100Reported as group
Quality
84.62
Improvement activities
40
Cost
76.68

Merit-based Incentive Payment System (MIPS)

Final score
68.81 of 100Reported as group
Quality
37.61
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75.84 of 100Reported as group
Quality
51.68
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Imaging Center/Ashburn, LLC CurrentSince Jan 30, 2023 Accepting new patients
Reston Radiology Consultants, PC CurrentSince Jan 30, 2023 Accepting new patients
Children's Hospital Current Accepting new patients
Loudoun Medical Group, PC CurrentSince Feb 1, 2023 Accepting new patients
Fair Oaks Imaging Center, PC CurrentSince Jan 30, 2023 Accepting new patients
Children's Hospital CurrentSince Jul 11, 2019 Accepting new patients
Children's Hospital CurrentSince Jul 11, 2019 Accepting new patients
Pet of Reston, LP CurrentSince Jan 30, 2023 Accepting new patients
Loudoun Medical Group, PC CurrentSince Feb 1, 2023 Accepting new patients
MRI of Reston, LP CurrentSince Jan 30, 2023 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

20905 Professional Plz
Ste 100
Ashburn, VA 20147
Phone (571) 223-0230

20116 Ashbrook Pl
Ste 150
Ashburn, VA 20147
Phone (703) 385-5203

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

4001 Fair Ridge Dr
Ste 103
Fairfax, VA 22033
Phone (703) 385-5203

19500 Sandridge Way
Ste 460
Leesburg, VA 20176
Phone (571) 206-0767

19500 Sandridge Way
Ste 420
Leesburg, VA 20176
Phone (571) 375-8601

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

1800 Town Center Dr
Ste 115
Reston, VA 20190
Phone (703) 478-0922

1830 Town Center Dr
Ste 105
Reston, VA 20190
Phone (571) 601-2901

4330 Brambleton Ave
Roanoke, VA 24018
Phone (540) 283-3700

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

Organizations & group practices 11

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 6

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": "1337385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1548520984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744785",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744785",
            "telephone_number": "202-476-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY, SUITE 420",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "571-375-8601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102916",
            "country_code": "US",
            "telephone_number": "202-476-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19500 Sandridge Way, Suite 460",
            "address_purpose": "LOCATION",
            "city": "leesburg",
            "state": "VA",
            "postal_code": "20176",
            "country_code": "US",
            "telephone_number": "571-206-0767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MA",
        "first_name": "GRACE",
        "middle_name": "MANG YUET",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-19",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "DC",
            "license": "MD047380",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "VA",
            "license": "0101266910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.