Individual provider Active NPI

Stefan W Leichtle, M.D.

  • Surgical Critical Care Physician
  • Fairfax, VA
National Provider Identifier
1700028172
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
0101259042 Issued in VA
Practice address
8260 Willow Oaks Corporate Dr Ste 600
Fairfax, VA 22031-4528
Phone
(571) 472-4670
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101259042 VA
Trauma Surgery Physician 2086S0127X 0101259042 VA
Surgical Critical Care Physician 2086S0102X 0101259042 VA Primary

Addresses

Primary practice location

8260 Willow Oaks Corporate Dr Ste 600
Fairfax, VA 22031-4528

Mailing address

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Other practice location 1

1250 E Marshall St
Richmond, VA 23298-5051
Phone (804) 828-7389

Other practice location 2

417 N 11th St
Richmond, VA 23298-5024
Phone (803) 828-7069

Other practice location 3

11958 W Broad St
Henrico, VA 23233-1007
Phone (804) 360-4669

Other practice location 4

9109 Stony Point Dr
Richmond, VA 23235-1979
Phone (804) 775-4500

Other practice location 5

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sleichtle1107736@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230210001078 DC Practitioner - General Surgery 7214180181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone (703) 237-3446

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
  • Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101
  • Fauquier Hospital Hospital, Warrenton, VA, CCN 490023

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101259042VAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Dec 5, 2022 Accepting new patients
Inova Health Care Services Trauma Surgery CurrentSince Dec 5, 2022 Accepting new patients

Locations

8260 Willow Oaks Corporate Dr
Ste 600
Fairfax, VA 22031
Phone (571) 472-4670

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: sleichtle1107736@soc.inova.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1700028172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 WILLOW OAKS CORPORATE DR STE 600",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314528",
            "telephone_number": "571-472-4670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-7389",
            "fax_number": "804-828-0191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "417 N 11th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985024",
            "country_code": "US",
            "telephone_number": "803-828-7069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11958 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Henrico",
            "state": "VA",
            "postal_code": "232331007",
            "country_code": "US",
            "telephone_number": "804-360-4669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9109 Stony Point Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232351979",
            "country_code": "US",
            "telephone_number": "804-775-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEICHTLE",
        "first_name": "STEFAN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101259042",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "VA",
            "license": "0101259042",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "VA",
            "license": "0101259042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sleichtle1107736@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8260 Willow Oaks Corporate Dr Ste 600",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.