Stephanie Marten-Ellis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

33931-TLG Issued in CA

Practice address

16311 Ventura Blvd Ste 750
Encino, CA 91436-4325

Phone

(747) 227-7412

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Gordon & Silvers Ods

  • Optometrist
  • Encino, CA
  • NPI 1235197062
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1477083178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 750",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 750",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364325",
            "telephone_number": "747-227-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTEN-ELLIS",
        "first_name": "STEPHANIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33931-TLG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9196T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine M Marroquin
• Giselle Marrufo
• Shaifali Marsh
• Catherine Marshall, M.D.
• Kevin Earl Marshall, M.D.
• Ana Martin
• Laurie Martin, MHSC. CCC-SLP
• Lilah Nicole Martin
• Marli Simone Martin
• Randy Martin, LAC, OMD, QME

• Optometrist in Encino, CA
• Providers in Encino, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.