Individual provider Active NPI

Sean O'Mara, MD

  • Emergency Medicine Physician
  • Leesburg, VA
National Provider Identifier
1841242963
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101239452 Issued in VA
Practice address
161 Fort Evans Rd NE Ste255
Leesburg, VA 20176
Phone
(703) 962-6721
Fax
(866) 269-0997
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101239452 VA Primary

Addresses

Primary practice location

161 Fort Evans Rd NE Ste255
Leesburg, VA 20176

Mailing address

161 Fort Evans Rd NE Ste 255
Leesburg, VA 20176
Phone (703) 962-6721

Other identifiers 1

IdentifierTypeStateIssuer
3810003148MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210128001003 MN Practitioner - Emergency Medicine 8325072507 Practice locations: Excelsior, MN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239452VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Emergency Medicine Physicians, LLC Past Accepting new patients
Valley Regional Enterprises, Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1841242963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 FORT EVANS RD NE STE 255",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-962-6721",
            "fax_number": "866-269-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT EVANS RD NE STE255",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-962-6721",
            "fax_number": "866-269-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARA",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101239452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003148",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.