Individual provider Active NPI

Cam Ma, OD

  • Optometrist
  • Vienna, VA
National Provider Identifier
1528140332
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0601800534 Issued in VA
Practice address
8359 Leesburg Pike
Vienna, VA 22182-2492
Phone
(703) 442-9295
Fax
(703) 749-0936
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601800534 VA Primary

Addresses

Primary practice location

8359 Leesburg Pike
Vienna, VA 22182-2492

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041022000142 DC Practitioner - Optometry 2062473192 Reassigns benefits to 1 organization
I20041116000456 VA Practitioner - Optometry 2062473192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0601800534VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Jun 13, 2025 Accepting new patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Jun 13, 2025 Accepting new patients

Locations

8125 Sudley Rd
Manassas, VA 20109
Phone (703) 330-0090

11130L South Lakes Dr
Reston, VA 20191
Phone (703) 471-1012

8359 Leesburg Pike
Vienna, VA 22182
Phone (703) 442-9285

8424 Old Keene Mill Rd
West Springfield, VA 22152
Phone (703) 288-1978

2700 Potomac Mills Cir
Ste 105
Woodbridge, VA 22192
Phone (703) 494-0660

Organizations & group practices 2

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528140332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 LEESBURG PIKE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822492",
            "telephone_number": "703-442-9295",
            "fax_number": "703-749-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "CAM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601800534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.