Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amber Nicole Pham, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1578132692

Amber Nicole Pham, PHYSICIANASSISTANT is a Physician Assistant in Leesburg, Virginia. Qualified in 2021, 5 years ago. Practices with Loudoun Medical Group, PC, a 274-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2021
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Practice location Address checks out

19490 Sandridge Way Ste 210
Leesburg, VA 20176-2704
Phone: (703) 723-7504
Fax: (703) 723-7550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110008022 (VA)

Record details

NPI number1578132692
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJune 22, 2021
Last updated in NPPESNovember 26, 2024
Certification dateNovember 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Loudoun Medical Group, Pc — 274 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Leesburg