MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC
NPI 1942883764
Clinic/Center - Ambulatory Surgical in Mc Lean, VA

NPI Status: Active since April 29, 2021

Contact Information

1760 OLD MEADOW RD
MC LEAN, VA
ZIP 22102
Phone: (860) 667-9542

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 49D2255598
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 03-15-2028

About MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Mclean Tysons Orthopedic Surgery Center, Llc, a provider established in Mc Lean, Virginia operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1942883764 assigned on April 2021. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Lucille Formeister (Dir. Bus Systems)

NPI
1942883764
Provider Name
MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC
Entity Type
Organization
Location Address
1760 OLD MEADOW RD MC LEAN, VA 22102
Location Phone
(860) 667-9542
Mailing Address
1760 OLD MEADOW RD MC LEAN, VA 22102
Mailing Phone
(860) 667-9542
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-29-2021
Last Update Date
04-29-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LUCILLE FORMEISTER

Authorized Official Title
DIR. BUS SYSTEMS
Authorized Official Phone
(860) 667-9542

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 41 times for 29 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 25 times for 22 patients

Release of wrist ligament using an endoscope

This procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.

This service was performed 15 times for 13 patients

Repair of shoulder rotator cuff using an endoscope

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

This service was performed 19 times for 19 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 17 times for 17 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
49D2255598
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
March 16, 2026
Certificate Expiration Date
March 15, 2028
Laboratory Director
WILLIAM MOOK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mclean Tysons Orthopedic Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1942883764, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 76. The final step is to find the difference between that total and the next multiple of ten (80 - 76 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
4
Doubled → 8
Pos 4
2
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
8
Unchanged
Pos 7
3
Doubled → 6
Pos 8
7
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 8 → 16 → 7 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 8 + 2 + 1 + 6 + 8 + 6 + 7 + 1 + 2 + 24 = 76

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 76 is 80. The difference is the calculated check digit.

80 - 76 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1942883764.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Clinic/Center (Physical Therapy)
1760 OLD MEADOW RD
MC LEAN, VA 22102
Physical Medicine & Rehabilitation
1760 OLD MEADOW RD, STE 500
MC LEAN, VA 22102
Nurse Practitioner (Family)
1760 OLD MEADOW RD
MC LEAN, VA 22102

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1942883764, enumerated as an "organization" on April 29, 2021.

The provider is located at 1760 OLD MEADOW RD MC LEAN, VA 22102 and the phone number is (860) 667-9542.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.