Active NPI
Vivian Lam
- Optometrist
- Chantilly, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618003536
- Practice address
- 25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918 - Phone
- (703) 957-3384
- Fax
- (703) 957-3387
- NPI assigned
- Jul 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Rehabilitation Optometrist | 152WL0500X | 0618003536 | VA | |
| Pediatric Optometrist | 152WP0200X | 0618003536 | VA | |
| Optometrist | 152W00000X | 0618003536 | VA | Primary |
Addresses
Primary practice location
25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918
Mailing address
25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918
Phone (703) 957-3384
Other practice location 1
21001 Sycolin Rd Ste 140
Ashburn, VA 20147-4074
Phone (703) 722-8688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0618003536 | VA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optometric Consultants of Virginia, Inc | Optometrist | Current | Accepting new patients |
Locations
21001 Sycolin Rd
Ste 140
Ashburn, VA 20147
Phone (703) 722-8688
5511 Merchants View Sq
Haymarket, VA 20169
Phone (703) 659-4430
25055 Riding Plz
Ste 100
South Riding, VA 20152
Phone (703) 957-3384
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.
-
- Optometrist
- Chantilly, VA
- NPI 1619285673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1982594586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25055 RIDING PLZ STE 100",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201525918",
"telephone_number": "703-957-3384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25055 RIDING PLZ STE 100",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201525918",
"telephone_number": "703-957-3384",
"fax_number": "703-957-3387"
}
],
"practiceLocations": [
{
"address_1": "21001 Sycolin Rd Ste 140",
"address_purpose": "LOCATION",
"city": "Ashburn",
"state": "VA",
"postal_code": "201474074",
"country_code": "US",
"telephone_number": "703-722-8688",
"fax_number": "703-957-3387",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAM",
"first_name": "VIVIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-07",
"last_updated": "2025-07-07",
"certification_date": "2025-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "VA",
"license": "0618003536",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "VA",
"license": "0618003536",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618003536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chantilly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.