Individual provider Active NPI

Sheri Lynn Demartelaere, M.D.

  • Ophthalmology Physician
  • Fort Sam Houston, TX
National Provider Identifier
1083605430
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
L8321 Issued in TX
Practice address
3851 Roger Brooke Dr
Brooke Army Medical Center, McHe-QD Credentials
Fort Sam Houston, TX 78234-4501
Phone
(210) 916-2460
NPI assigned
Nov 3, 2005
Last updated
Apr 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X L8321 TX Primary

Addresses

Primary practice location

3851 Roger Brooke Dr
Brooke Army Medical Center, McHe-QD Credentials
Fort Sam Houston, TX 78234-4501

Mailing address

3551 Roger Brooke Dr Quality Services/7TH Floor
Brooke Army Medical Center, Attn: McHe-ZQQ
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-2338

Other identifiers 1

IdentifierTypeStateIssuer
167473101MedicaidTX

Other names 1

  • Sheri L. Demartelaere Professional name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L8321TXMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1083605430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR QUALITY SERVICES/7TH FLOOR",
            "address_2": "BROOKE ARMY MEDICAL CENTER, ATTN: MCHE-ZQQ",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR",
            "address_2": "BROOKE ARMY MEDICAL CENTER, MCHE-QD CREDENTIALS",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344501",
            "telephone_number": "210-916-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARTELAERE",
        "first_name": "SHERI",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L8321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167473101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERI",
            "last_name": "DEMARTELAERE",
            "middle_name": "L.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.