Individual provider Active NPI

Julie Mai Demaggio, OD

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1255613238
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8477T Issued in TX
Practice address
5325 McPherson Blvd Ste 125
Fort Worth, TX 76123-6028
Phone
(817) 935-8280
NPI assigned
Sep 15, 2011
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8477T TX Primary

Addresses

Primary practice location

5325 McPherson Blvd Ste 125
Fort Worth, TX 76123-6028

Mailing address

1603 Hackney Dr
Mansfield, TX 76063-4262
Phone (214) 728-9895

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
I20141224000459 TX Practitioner - Optometry 0446573448 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midlothian Vision Associates PLLCGroup PAC ID 3971842683, 5 clinicians

Practice addresses (Care Compare)

1669 S 9TH St
Suite 200
Midlothian, TX 76065-3754
Phone (972) 775-4040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8477TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midlothian Vision Associates, PLLC Optometrist CurrentSince Aug 3, 2021 Accepting new patients
Enhanced Eye Care Texas Optometrist CurrentSince Nov 14, 2022 Accepting new patients
Plano Eye Associates PC Optometrist CurrentSince Oct 9, 2014 Accepting new patients
Eyes on Lone Star Optometrist PastSince Apr 3, 2022 Accepting new patients

Locations

5325 McPherson Blvd
Fort Worth, TX 76123

5325 McPherson Blvd
Ste 125
Fort Worth, TX 76123
Phone (817) 935-8280

1650 Highway 287 N
Mansfield, TX 76063
Phone (682) 518-1177

1669 S 9th St
Ste 200
Midlothian, TX 76065
Phone (972) 775-4040

5900 Coit Rd
Plano, TX 75023
Phone (972) 985-1412

5900 Coit Rd
Ste 110
Plano, TX 75023

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1255613238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 HACKNEY DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634262",
            "telephone_number": "214-728-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 MCPHERSON BLVD STE 125",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761236028",
            "telephone_number": "817-935-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAGGIO",
        "first_name": "JULIE",
        "middle_name": "MAI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8477T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.