Active NPI
Walter A. Martin, CRNA
- Certified Registered Nurse Anesthetist
- Hagerstown, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R148205
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R148205 | Other | MD | LICENSE MARYLAND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| R148205 | MD | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Maryland Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Comfort Sedation LLC | Current | Accepting new patients | |
| Mid-Maryland Anesthesia LLC | Current | Accepting new patients | |
| Maryland Anesthesia Partners LLC | Nurse Anesthetist, Certified Registered | Current | 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.
-
- Certified Registered Nurse Anesthetist
- Ijamsville, MD
- NPI 1457829103
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Frederick, MD
- NPI 1669866489
-
- Anesthesiology Physician
- Frederick, MD
- NPI 1356799977
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Hagerstown, MD
- NPI 1407964646
Nurse Anesthetist, Certified Registered
-
- Specialist
- Frederick, MD
- NPI 1598106239
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.