Sandra Kay Marotta, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000113 Issued in VA

Practice address

13029 Lee Jackson Memorial Hwy
Fairfax, VA 22033-2001

Phone

(703) 322-2020

Fax

(703) 322-1221

NPI assigned

Sep 15, 2006

Last updated

Dec 8, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Sandra Kay Riddle Former name

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenbriar Vision Center, IncGroup PAC ID 1153504014, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenbriar Vision Center, Inc

  • Clinic/Center
  • Fairfax, VA
  • NPI 1609165653

  DC

  Medicare reassignment Care Compare group NPD
• Larry N London OD

  dba Virginia Vision Associates

  • Optometric Technician
  • Arlington, VA
  • NPI 1639578529
  NPD (past)
• Virginia Vision Associates Optometry PLLC

  dba Virginia Vision Associates

  • Optometrist
  • Arlington, VA
  • NPI 1295826220
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1396841979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13029 LEE JACKSON MEMORIAL HWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332001",
            "telephone_number": "703-322-2020",
            "fax_number": "703-322-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13029 LEE JACKSON MEMORIAL HWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332001",
            "telephone_number": "703-322-2020",
            "fax_number": "703-322-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROTTA",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "541660280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "VA1534",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCI MOMS",
            "identifier": "411854",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5671134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "RIDDLE",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allyson Markussen, LPC
• Andrea Rae Markway, AUD, CCC-A
• Marna Rowe Counseling LLC
• Leslie Maron, LPC, LCPC
• Nicholas James Marotta, O.D.
• Kathryn Marqueen, MD
• Jeanne Marie Marquis, PHD
• Maria S Marris
• Christopher Robert Marrow, PT
• Amy Marshall

• Optometrist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.