Individual provider Active NPI

Marie Lulette Pinto Fermil, OD

  • Optometrist
  • El Paso, TX
National Provider Identifier
1063728277
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002793 Issued in VA
Practice address
1325 George Dieter Dr Ste I2
El Paso, TX 79936-7484
Phone
(915) 591-8800
NPI assigned
Aug 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Technician/Technologist 156F00000X
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 0618002793 VA Primary

Addresses

Primary practice location

1325 George Dieter Dr Ste I2
El Paso, TX 79936-7484

Mailing address

7364 Brays Landing Dr
El Paso, TX 79911-3101
Phone (925) 978-3248

Other practice location 1

126 Missouri Ave
Box 1263
Fort Leonard Wood, MO 65473-8952
Phone (573) 596-0048

Other practice location 2

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100

Other practice location 3

5005 North Piedras Street
El Paso, TX 79920
Phone (925) 978-3248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230419001668 TX Practitioner - Optometry 2769857044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

1325 George Dieter Dr
Suite I2
El Paso, TX 79936-7484
Phone (915) 587-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002793VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Goff & Falknor PA Optometrist CurrentSince Mar 1, 2023 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Mar 1, 2023 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

1325 George Dieter Dr
Ste I2
El Paso, TX 79936
Phone (915) 587-9400

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

Organizations & group practices 3

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": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1063728277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7364 BRAYS LANDING DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799113101",
            "telephone_number": "925-978-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 GEORGE DIETER DR STE I2",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367484",
            "telephone_number": "915-591-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Missouri Ave",
            "address_2": "Box 1263",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654738952",
            "country_code": "US",
            "telephone_number": "573-596-0048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5005 North Piedras Street",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79920",
            "country_code": "US",
            "telephone_number": "925-978-3248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERMIL",
        "first_name": "MARIE LULETTE",
        "middle_name": "PINTO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.