Individual provider Active NPI

Valerie Elise Marten-Ellis, O.D.

  • Optometrist
  • Killeen, TX
National Provider Identifier
1356751267
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8369TG Issued in TX
Practice address
2301 S Clear Creek Rd
Suite 116
Killeen, TX 76549-4143
Phone
(254) 526-5505
Fax
(254) 526-4313
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8369TG TX Primary

Addresses

Primary practice location

2301 S Clear Creek Rd
Suite 116
Killeen, TX 76549-4143

Mailing address

2301 S Clear Creek Rd
Suite 116
Killeen, TX 76549-4143
Phone (254) 526-5505

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
I20150115000169 TX Practitioner - Optometry 5698099901 Reassigns benefits to 1 organization
Practice locations: Killeen, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Optometrists PCGroup PAC ID 8022004597, 4 clinicians

Practice addresses (Care Compare)

2806 S W S Young Dr a
Central Killeen Vision Source
Killeen, TX 76542-2011
Phone (254) 634-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8369TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Optometrists, P.C. Optometrist CurrentSince Jun 27, 2021 Accepting new patients
Consolidated Opticals of Texas, Inc. Past Accepting new patients

Locations

98 Cove Terrace Shopping Ctr
Copperas Cove, TX 76522
Phone (254) 542-2020

2806 S W S Young Dr
Ste A
Killeen, TX 76542
Phone (254) 634-4800

2910 Market Loop
Temple, TX 76502
Phone (254) 778-6165

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, 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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1356751267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S CLEAR CREEK RD",
            "address_2": "SUITE 116",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494143",
            "telephone_number": "254-526-5505",
            "fax_number": "254-526-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S CLEAR CREEK RD",
            "address_2": "SUITE 116",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494143",
            "telephone_number": "254-526-5505",
            "fax_number": "254-526-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTEN-ELLIS",
        "first_name": "VALERIE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8369TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.