Individual provider Active NPI

Earl Joseph Primo, O. D.

  • Optometrist
  • Covington, LA
National Provider Identifier
1326015751
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1332-466T Issued in LA
Practice address
880 N Highway 190
Covington, LA 70433-5147
Phone
(985) 867-8708
Fax
(985) 867-8711
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1332-466T LA Primary

Addresses

Primary practice location

880 N Highway 190
Covington, LA 70433-5147

Mailing address

205 Stonewood Dr
Covington, LA 70433-5819
Phone (504) 606-1701

Other identifiers 1

IdentifierTypeStateIssuer
1153796MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041004000005 LA Practitioner - Optometry 2961471248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

880 N Hwy 190
Covington, LA 70433-5147
Phone (985) 867-8708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Family Eyecare, LLC Optometrist CurrentSince Mar 24, 2014 Accepting new patients
Earl J Primo Ms OD LLC Optometrist CurrentSince May 11, 2008 Accepting new patients

Locations

1431 Ochsner Blvd
Ste A
Covington, LA 70433
Phone (985) 302-5225

107 Terra Bella Blvd
Covington, LA 70433
Phone (985) 875-7898

880 N Highway 190
Covington, LA 70433
Phone (985) 867-8708

3909 Lapalco Blvd
Ste 201
Harvey, LA 70058
Phone (504) 328-9733

Organizations & group practices 2

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1326015751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 STONEWOOD DR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335819",
            "telephone_number": "504-606-1701",
            "fax_number": "985-871-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 N HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335147",
            "telephone_number": "985-867-8708",
            "fax_number": "985-867-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMO",
        "first_name": "EARL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1332-466T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1153796",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.