Individual provider Active NPI

Christopher Marmo, O.D.

  • Optometrist
  • Peoria, AZ
National Provider Identifier
1932197506
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001437 Issued in AZ
Practice address
21655 N Lake Pleasant Pkwy
Peoria, AZ 85382-7436
Phone
(623) 537-4595
Fax
(602) 437-3498
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001437 AZ Primary
Optometrist 152W00000X OPT-001437 AZ

Addresses

Primary practice location

21655 N Lake Pleasant Pkwy
Peoria, AZ 85382-7436

Mailing address

1104 W Lydia LN
Phoenix, AZ 85041-5924
Phone (480) 961-1865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050718000790 AZ Practitioner - Optometry 2163459595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3330 N 2ND St
Suite 500
Phoenix, AZ 85012-2367
Phone (602) 910-0069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-001437AZMDOptometrist
OPT001437AZMDOptometrist
1437AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CL Eye Care, PLLC Optometrist CurrentSince May 29, 2008 Accepting new patients
Walman Eye Center, LLC Past Accepting new patients
Lilien Vogl OD PC Past Accepting new patients

Locations

21655 N Lake Pleasant Pkwy
Peoria, AZ 85382
Phone (623) 537-4591

3330 N 2nd St
Ste 500
Phoenix, AZ 85012
Phone (602) 910-0069

Organizations & group practices 3

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1932197506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W LYDIA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415924",
            "telephone_number": "480-961-1865",
            "fax_number": "480-961-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21655 N LAKE PLEASANT PKWY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827436",
            "telephone_number": "623-537-4595",
            "fax_number": "602-437-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMO",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT001437",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-001437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.