Individual provider Active NPI

Marielle Mahan, MD

  • Ophthalmology Physician
  • Bethesda, MD
National Provider Identifier
1487115010
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0103387 Issued in MD
Practice address
5612 Shields Dr
Bethesda, MD 20817-3532
Phone
(301) 571-4334
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X D0103387 MD
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X MD600004334 DC
Ophthalmology Physician 207W00000X MD600004334 DC
Ophthalmology Physician 207W00000X D0103387 MD Primary

Addresses

Primary practice location

5612 Shields Dr
Bethesda, MD 20817-3532

Mailing address

11300 Rockville Pike Ste 1202
Rockville, MD 20852-3040
Phone (301) 896-0890

Other practice location 1

811 Russell Ave Ste H
Gaithersburg, MD 20879-3510
Phone (301) 571-4334

Other practice location 2

4301 Connecticut Ave NW Ste 125
Washington, DC 20008-2332
Phone (301) 896-0890

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250926003205 DC Practitioner - Ophthalmology 5294192365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Georgetown University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Ophthalmology LLCGroup PAC ID 4587795687, 17 clinicians

Practice addresses (Care Compare)

4301 Connecticut Ave NW
Suite 125
Washington, DC 20008-2332
Phone 3018960890148

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD600004334DCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Ophthalmology LLC Ophthalmology CurrentSince Sep 1, 2025 Accepting new patients

Locations

4301 Connecticut Ave NW
Ste 125
Washington, DC 20008
Phone (202) 362-4545

5612 Shields Dr
Bethesda, MD 20817
Phone (301) 571-4334

811 Russell Ave
Ste H
Gaithersburg, MD 20879
Phone (301) 571-4334

11300 Rockville Pike
Ste 1202
Rockville, MD 20852
Phone (301) 896-0890

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1487115010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 ROCKVILLE PIKE STE 1202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523040",
            "telephone_number": "301-896-0890",
            "fax_number": "301-896-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5612 SHIELDS DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173532",
            "telephone_number": "301-571-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 Russell Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208793510",
            "country_code": "US",
            "telephone_number": "301-571-4334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 Connecticut Ave NW Ste 125",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200082332",
            "country_code": "US",
            "telephone_number": "301-896-0890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "MARIELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "MD",
            "license": "D0103387",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "DC",
            "license": "MD600004334",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DC",
            "license": "MD600004334",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0103387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.