NPIMap

Organization Active NPI

Marc Ellman, M.D., P.a.

Doing business as Southwest Eye Institute

  • Ophthalmology Physician
  • El Paso, TX
National Provider Identifier
1053530907
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MARC ELLMAN, M.D., P.A.
Doing business as
Southwest Eye Institute
Practice address
1400 Common Dr
El Paso, TX 79936-5922
Phone
(915) 595-4375
Fax
(915) 595-4460
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Dr. Arthur D Brookfield
Title
Cfo
Phone
(602) 598-7488

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1400 Common Dr
El Paso, TX 79936-5922

Mailing address

63 S Rockford Dr Ste 220
Tempe, AZ 85288-6226
Phone (602) 598-7488

Other identifiers 1

IdentifierTypeStateIssuer
168078702MedicaidTX

Other names 1

  • Southwest Eye Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040902000321 TX Part B Supplier - Clinic/Group Practice 2264408152 Receives reassigned benefits from 28 practitioners
Practice locations: El Paso, TX
O20210930000074 NM Part B Supplier - Clinic/Group Practice 2264408152 Receives reassigned benefits from 12 practitioners
Practice locations: Deming, NM; Las Cruces, NM

National Provider Directory

National Provider Directory

Locations

2301 Saturn Cir
Las Cruces, NM 88012
Phone (575) 382-0014

1324 N Yarbrough Dr
El Paso, TX 79925
Phone (915) 595-4375

1030 N Zaragoza Rd
Ste D
El Paso, TX 79907
Phone (915) 267-2020

150 S Resler Dr
El Paso, TX 79912
Phone (915) 267-2020

1030 N Zaragoza Rd
Ste V
El Paso, TX 79907
Phone (915) 859-8594

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1053530907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 S ROCKFORD DR STE 220",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852886226",
            "telephone_number": "602-598-7488",
            "fax_number": "602-231-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COMMON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365922",
            "telephone_number": "915-595-4375",
            "fax_number": "915-595-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC ELLMAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BROOKFIELD",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-598-7488",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168078702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwest Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.