Individual provider Active NPI

Marya Siddiq, OD

  • Optometrist
  • Bristow, VA
National Provider Identifier
1750130035
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003419 Issued in VA
Practice address
10338 Bristow Center Dr
Bristow, VA 20136-2201
Phone
(703) 392-1010
NPI assigned
May 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003419 VA Primary

Addresses

Primary practice location

10338 Bristow Center Dr
Bristow, VA 20136-2201

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20240624003924 DC Practitioner - Optometry 8921541590 Reassigns benefits to 2 organizations
I20240716000158 VA Practitioner - Optometry 8921541590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Virginia, PLLC 133 clinicians

Practice addresses (Care Compare)

10338 Bristow Ctr Dr
Bristow, VA 20136-2201
Phone (703) 392-1010

14465 Potomac Mills Rd
Woodbridge, VA 22192-6807
Phone (703) 494-6184

44727 Brimfield Dr
Ashburn, VA 20147-5920
Phone (571) 385-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618003419VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Silk Vision and Surgical Center CurrentSince Jul 1, 2024 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist Current Accepting new patients

Locations

3301 Woodburn Rd
Ste 308
Annandale, VA 22003
Phone (703) 876-9700

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

10338 Bristow Center Dr
Bristow, VA 20136
Phone (703) 392-1010

5765 Burke Centre Pkwy
Ste L
Burke, VA 22015
Phone (703) 250-2000

14245P Centreville Sq
Centreville, VA 20121
Phone (703) 830-2010

3910 Centreville Rd
Ste 100
Chantilly, VA 20151
Phone (703) 830-6380

14337 Newbrook Dr
Ste 400
Chantilly, VA 20151
Phone (571) 512-5990

5809 Leesburg Pike
Falls Church, VA 22041
Phone (866) 693-9336

7367 Atlas Walk Way
Gainesville, VA 20155
Phone (703) 753-7200

8405 Dorsey Cir
Ste 101
Manassas, VA 20110
Phone (571) 229-9183

9930 Sowder Village Sq
Ste 220
Manassas, VA 20109
Phone (703) 368-2121

9675 Liberia Ave
Ste 108
Manassas, VA 20110
Phone (703) 331-2122

6406 Springfield Plz
Springfield, VA 22150
Phone (703) 451-4577

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

14465 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 494-6184

Interoperability endpoints

  • Direct secure messaging: msiddiq@svsc.intellechartdirect.net

Organizations & group practices 9

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": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1750130035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10338 BRISTOW CENTER DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362201",
            "telephone_number": "703-392-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQ",
        "first_name": "MARYA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, VA

Sources for this page

Verify at the official NPI Registry.