Martinsburg Eye Associates PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

19369 Issued in WV

Legal business name

MARTINSBURG EYE ASSOCIATES PLLC

Practice address

2002 Professional CT
Martinsburg, WV 25401-8808

Phone

(304) 267-4273

NPI assigned

Oct 27, 2006

Last updated

Nov 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kathleen Householder

Title

Office Manager

Phone

(304) 267-4273

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: mpromersberger@mea.intellechartdirect.net
• Direct secure messaging: knazari@mea.intellechartdirect.net

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Louis Dobbins, O.D.

  • Optometrist
  • Martinsburg, WV
  • NPI 1275796229
  Medicare reassignment Care Compare group NPD
• Mark Edward Promersberger, M.D.

  • Ophthalmology Physician
  • Martinsburg, WV
  • NPI 1760415228
  Medicare reassignment Care Compare group NPD
• Kourosh Nazari, M.D.

  • Ophthalmology Physician
  • Deland, FL
  • NPI 1881685741

  WV

  Medicare reassignment Care Compare group NPD
• Tamim Qaum, MD

  • Ophthalmology Physician
  • Wichita, KS
  • NPI 1609817022

  WV

  Medicare reassignment NPD
• Jerry Allen Fogle, M.D.

  • Ophthalmology Physician
  • Martinsburg, WV
  • NPI 1093748576
  NPD (past)
• Lawrence F Brack III, M.D.

  • Ophthalmology Physician
  • Lithonia, GA
  • NPI 1265441315
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1467538967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 PROFESSIONAL CT",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018808",
            "telephone_number": "304-267-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 PROFESSIONAL CT",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018808",
            "telephone_number": "304-267-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINSBURG EYE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "HOUSEHOLDER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-267-4273",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "19369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202125000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Marlise Martin, SLP
• Tammy Sue Martin, APRN, NP-C
• Arianna Martinez
• Lisa Martinez
• Martinsburg Center LLC (Clary Grove)
• Martinsburg Family Eye Care, PLLC (Martinsburg Family Eye Care)
• Martinsburg Institute Inc
• Martinsburg Internal Medicine Assoc Inc
• Martinsburg Internal Medicine Assoc Inc (Martinsburg Internal Medicine Lab)
• Martinsburg Optical Inc

• Ophthalmology Physician in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Ophthalmology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.