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

Antonietta E Vaillancourt, PA

Individual provider Surgical Physician Assistant · NPI 1811403033

Antonietta E Vaillancourt, PA is a Physician Assistant in Gaithersburg, Maryland. Qualified in 2017, 9 years ago. Practices with Medstar Urgent Care LLC, a 299-clinician group and accepts Medicare assignment. Licensed in Hawaii and Maryland.

Years since qualifying
9
Licensed in
HI, MD
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

9561 White Pillar Ter
Gaithersburg, MD 20882-2816
Phone: (301) 641-8354
Fax: (301) 641-8354
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence C06707 (MD)
Medical Physician Assistant Taxonomy 363AM0700X · Licence AMD-789 (HI)

Record details

NPI number1811403033
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 26, 2017
Last updated in NPPESFebruary 20, 2024
Certification dateFebruary 20, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Medstar Urgent Care Llc — 299 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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