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Loudoun Medical Group, PC

Organization Active NPI Orthopaedic Foot and Ankle Surgery Physician · Leesburg, VA

NPI 1992318067 · NPPES record last updated Aug 18, 2023

Key facts

NPI
1992318067
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X
Legal business name
LOUDOUN MEDICAL GROUP, PC
Practice address
224-D Cornwall St, NW
Suite 204
Leesburg, VA 20176-2700
Phone
(703) 737-6000
NPI assigned
Aug 28, 2020
Organization subpart
Yes
Parent organization (as reported)
LOUDOUN MEDICAL GROUP, PC

Authorized official

Name
Mary Beth Tamasy
Title
Ceo
Phone
(703) 737-6010

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.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 15

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 272

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 272

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200911001968 VA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0042119661 Practice locations: Leesburg, VA

National Provider Directory

Tax ID family
Walter M Obrien MD (305 organizations share this tax ID)
Part of
Walter M Obrien MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207X00000X
Orthopaedic Foot and Ankle Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207XX0004X Yes

Addresses

Primary practice location

224-D Cornwall St, NW
Suite 204
Leesburg, VA 20176-2700

Mailing address

224D Cornwall St NW Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6000

Other names

  • Loudoun Medical Group, PC DME Doing business as

Other providers in Leesburg, VA

All providers in Leesburg, VA · Orthopaedic Foot and Ankle Surgery Physician in Virginia

Sources for this page

Verify at the official NPI Registry.