AMANDA LEE THACKER FNP
NPI 1114621810
Nurse Practitioner - Family in Leesburg, VA

Q: What is Amanda Thacker's NPI number?

The NPI number for Amanda Thacker is 1114621810. It was assigned to this individual provider in the NPPES registry on March 28, 2023.

Q: What is Amanda Thacker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Thacker was last updated on March 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 28, 2023PECOS EnrolledAccepts Medicare Assignment

19450 DEERFIELD AVENUE, SUITE 200, LEESBURG, VA 20176(703) 844-8380(703) 263-8393 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2024, May 30, 2023, Mar 28, 2023 (3 updates tracked since 2023).

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About Amanda Lee Thacker Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA LEE THACKER FNP (NPI 1114621810) is an individual family provider in Leesburg, Virginia, licensed in Virginia (0024185322) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Fairfax, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1114621810

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMANDA LEE THACKERCredential: FNP

Location Address19450 DEERFIELD AVENUE, SUITE 200Leesburg, VA 20176-6821

Mailing Address224-d Cornwall St., Nw, Suite 403Leesburg, VA 20176-2704 · (703) 737-6010 · Fax (703) 443-8643

Phone(703) 844-8380

Fax(703) 263-8393

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMarch 28, 2023

Last NPPES UpdateMarch 6, 20243 updates tracked since enumeration

NPPES CertifiedMarch 6, 2024

✔ NPI 1114621810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in VA · 0024185322

19450 DEERFIELD AVENUE, SUITE 200, Leesburg, VA 20176

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Secondary Practice Location 1

Location 13022 Williams Dr Ste 100Fairfax, VA 22031-4600 · Phone (703) 698-9400

Other Identifiers 2

Medicaid30017651500001VA

Medicaid1114621810VA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda Lee Thacker Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204297690

PECOS Enrollment IDI20230801004318

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

232 services105 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

59 services27 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

26 services26 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20176 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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