Vita Family Medicine and Medspa LLC
NPI 1730532359ActiveOrganization· Family Medicine· Leesburg, VA
Family Medicine in Leesburg, Virginia, registered in NPPES in July 2016. The authorized official on file is Jennifer Boudreau, M.D, Owner/Doctor. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1730532359 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 19, 2016 |
| Last updated in NPPES | Oct 13, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | VA |
| Clinic/Center, Primary Care | 261QP2300X | 0101258315 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (VA) |
|---|
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