Individual provider Active NPI

Maisie Irene Martinick, M.D.

  • Anesthesiology Physician
  • Richmond, VA
National Provider Identifier
1013232230
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
272924 Issued in NY
Practice address
1200 E. Broad Street West Hospital - W6S
Gme Administration Pob 980257
Richmond, VA 23298-0257
Phone
(804) 828-9783
Fax
(804) 828-5613
NPI assigned
Mar 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9544203 NY
Anesthesiology Physician 207L00000X 0101257763 VA
Anesthesiology Physician 207L00000X 272924 NY Primary

Addresses

Primary practice location

1200 E. Broad Street West Hospital - W6S
Gme Administration Pob 980257
Richmond, VA 23298-0257

Mailing address

5300 Military Road
Mount St. Mary'S Hospital
Lewiston, NY 14092
Phone (716) 297-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170710002127 NY Practitioner - AnesthesiologyPractitioner - General Surgery 1254659709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple Gate Anesthesiologists, P.C.Group PAC ID 8022913839, 113 clinicians

Practice addresses (Care Compare)

818 Ellicott St
Buffalo, NY 14203-1021
Phone (716) 632-1088

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
272924NYMDAnesthesiology Physician
9544203NYMDAnesthesiology Physician
0101257763VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Gate Anesthesiologists, P.C. Anesthesiology CurrentSince Apr 16, 2024 Accepting new patients
Parkside Medical Anesthesia Associates Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients

Locations

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2568 Walden Ave
Ste 103
Cheektowaga, NY 14225

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

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 6

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": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1013232230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 MILITARY ROAD",
            "address_2": "MOUNT ST. MARY'S HOSPITAL",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "14092",
            "telephone_number": "716-297-4800",
            "fax_number": "804-828-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E. BROAD STREET WEST HOSPITAL - W6S",
            "address_2": "GME ADMINISTRATION POB 980257",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-9783",
            "fax_number": "804-828-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINICK",
        "first_name": "MAISIE",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "9544203",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101257763",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "272924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.