NPIMap

Organization Active NPI

Loudoun Medical Group, PC

Doing business as Mancini and Korkowski

  • Internal Medicine Physician
  • Leesburg, VA
National Provider Identifier
1609900208
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Doing business as
Mancini and Korkowski
Martin A. Korkowski, MD
Practice address
44055 Riverside Pkwy Ste 216
Leesburg, VA 20176-5176
Phone
(703) 858-1395
Fax
(703) 858-7468
NPI assigned
Mar 15, 2007
Last updated
Aug 18, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LOUDOUN MEDICAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Mary Beth Tamasy
Title
Ceo
Phone
(703) 737-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

44055 Riverside Pkwy Ste 216
Leesburg, VA 20176-5176

Mailing address

224D Cornwall St NW Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6001

Other identifiers 2

IdentifierTypeStateIssuer
CG8678OtherVARR MEDICARE PIN
CG8680OtherDCRR MEDICARE PIN

Other names 2

  • Mancini and Korkowski Doing business as
  • Martin A. Korkowski, MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041115000474 VA Part B Supplier - Clinic/Group Practice 0042119661 Receives reassigned benefits from 340 practitioners
32 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Tax ID family
John M Archer MD305 organizations share this tax ID, including this one
Part of
John M Archer MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1609900208",
    "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": "703-737-6001",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44055 RIVERSIDE PKWY STE 216",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765176",
            "telephone_number": "703-858-1395",
            "fax_number": "703-858-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN MEDICAL GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUDOUN MEDICAL GROUP, PC",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "TAMASY",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-737-6001"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "CG8678",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "CG8680",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mancini and Korkowski",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martin A. Korkowski, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.