NPIMap

Individual provider Active NPI

Robert Lowell Hetzel, MD

  • Family Medicine Physician
  • Leesburg, VA
National Provider Identifier
1811980329
Registry record updated Jan 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101232586 Issued in VA
Practice address
224D Cornwall St NW
Suite 106
Leesburg, VA 20176-2700
Phone
(703) 777-1612
Fax
(703) 777-2368
NPI assigned
Aug 30, 2005
Last updated
Jan 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101232586 VA Primary

Addresses

Primary practice location

224D Cornwall St NW
Suite 106
Leesburg, VA 20176-2700

Mailing address

PO Box 17334
Baltimore, MD 21297-1334
Phone (703) 443-6717

Other identifiers 4

IdentifierTypeStateIssuer
010105706MedicaidVA
010105731MedicaidVA
010105757MedicaidVA
P00270260OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427000493 VA Practitioner - Family Practice 2769479369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 1999
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)

224 D Cornwall St NW
Suite 106
Leesburg, VA 20176-2700
Phone (703) 777-1612

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22198SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Nov 15, 2004 Accepting new patients
Loudoun Medical Group, PC Family Medicine CurrentSince Nov 15, 2004 Accepting new patients
Hillsville Family Medicine, PLLC Family Medicine Past Accepting new patients
Ralph J. Hasspieler, M.D. P.C. Family Medicine Past Accepting new patients
Carroll Family Physicians Inc Family Medicine Past Accepting new patients
Yung C. Chan, M.D. P.C. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

224D Cornwall St NW
Ste 106
Leesburg, VA 20176
Phone (703) 777-1411

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

44084 Riverside Pkwy
Ste 300
Leesburg, VA 20176
Phone (703) 724-7530

Interoperability endpoints

  • Direct secure messaging: robert.hetzel@lmg1.eclinicaldirectplus.com

Organizations & group practices 7

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 11

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262995200000",
    "number": "1811980329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17334",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212971334",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224D CORNWALL ST NW",
            "address_2": "SUITE 106",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762700",
            "telephone_number": "703-777-1612",
            "fax_number": "703-777-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZEL",
        "first_name": "ROBERT",
        "middle_name": "LOWELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101232586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010105706",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010105731",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010105757",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00270260",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.