Individual provider Active NPI

Walter A. Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Hagerstown, MD
National Provider Identifier
1003969585
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R148205 Issued in MD
Practice address
251 E Antietam St
Hagerstown, MD 21740-5724
Phone
(302) 709-4497
Fax
(302) 733-0854
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R148205 MD Primary

Addresses

Primary practice location

251 E Antietam St
Hagerstown, MD 21740-5724

Mailing address

251 E Antietam St
Hagerstown, MD 21740-5724
Phone (302) 709-4497

Other identifiers 1

IdentifierTypeStateIssuer
R148205OtherMDLICENSE MARYLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071010000594 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739275413 Reassigns benefits to 3 organizations
I20100617000340 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739275413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comfort Sedation LLCGroup PAC ID 2567464423, 4 clinicians
Maryland Anesthesia Partners LLCGroup PAC ID 4284971235, 4 clinicians
Mid-Maryland Anesthesia LLCGroup PAC ID 5890014542, 3 clinicians

Practice addresses (Care Compare)

10110 Molecular Dr
Suite 100
Rockville, MD 20850-7538
Phone (301) 838-0437

3280 Urbana Pike
Suite 104
Ijamsville, MD 21754-9411
Phone (240) 436-6440

85 Thomas Johnson CT C
Frederick, MD 21702-4331
Phone (301) 663-9440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R148205MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Maryland Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Comfort Sedation LLC CurrentSince Aug 1, 2025 Accepting new patients
Mid-Maryland Anesthesia LLC CurrentSince Apr 22, 2024 Accepting new patients
Maryland Anesthesia Partners LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2024 Accepting new patients
Digestive Disease Solutions, LLC Past Accepting new patients
Blue Ridge Anesthesia Associates LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

85 Thomas Johnson Ct
Ste C
Frederick, MD 21702
Phone (301) 663-9440

165 Thomas Johnson Dr
Ste Bc
Frederick, MD 21702
Phone (240) 463-1189

3280 Urbana Pike
Ste 104
Ijamsville, MD 21754
Phone (240) 436-6440

10110 Molecular Dr
Ste 100
Rockville, MD 20850
Phone (301) 838-0437

Organizations & group practices 6

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1003969585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E ANTIETAM ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405724",
            "telephone_number": "302-709-4497",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E ANTIETAM ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405724",
            "telephone_number": "302-709-4497",
            "fax_number": "302-733-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WALTER",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R148205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE MARYLAND",
            "identifier": "R148205",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.