Individual provider Active NPI

William Matthew Martin, SRNA

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1003564220
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11033037 Issued in FL
Practice address
1 Tampa General Cir
Tampa, FL 33606-3571
Phone
(501) 413-3150
NPI assigned
Mar 16, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9448209 FL
Certified Registered Nurse Anesthetist 367500000X APRN11033037 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

3112 W Empedrado St Apt 12
Tampa, FL 33629-7241
Phone (501) 413-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624003335 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698218246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf-to-Bay Anesthesiology Associates LLCGroup PAC ID 5092628156, 330 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9448209FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Jun 24, 2024 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Jun 24, 2024 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1003564220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 W EMPEDRADO ST APT 12",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336297241",
            "telephone_number": "501-413-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "501-413-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WILLIAM",
        "middle_name": "MATTHEW",
        "credential": "SRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-16",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9448209",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11033037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.