Individual provider Active NPI

Matthew Martin

  • Diagnostic Radiology Physician
  • Laurel, MS
National Provider Identifier
1023579190
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
32831 Issued in MS
Practice address
1220 Jefferson St
Laurel, MS 39440-4355
Phone
(601) 428-0100
Fax
(601) 428-0100
NPI assigned
Mar 29, 2019
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 32831 MS Primary

Addresses

Primary practice location

1220 Jefferson St
Laurel, MS 39440-4355

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 399-6169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20250414001321 MS Practitioner - Diagnostic Radiology 5890024830 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates, PAGroup PAC ID 2163404625, 4 clinicians
Magee Benevolent AssociationGroup PAC ID 3678466463, 19 clinicians

Practice addresses (Care Compare)

1220 Jefferson St
Laurel, MS 39440-4355
Phone (601) 426-4000

300 3Rd Ave SE
Magee, MS 39111-3665
Phone (601) 849-5070

300 3Rd Ave SE Northwing
Magee, MS 39111-3665
Phone (601) 849-7702

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Feb 9, 2025 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Feb 9, 2025 Accepting new patients
South Central Regional Medical Center CurrentSince Feb 1, 2026 Accepting new patients
South Central Regional Medical Center CurrentSince Feb 1, 2026 Accepting new patients
Radiology Associates, PA Diagnostic Radiology CurrentSince May 2, 2025 Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000

227 S 13th Ave
Laurel, MS 39440
Phone (601) 428-0100

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1023579190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6169",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404355",
            "telephone_number": "601-428-0100",
            "fax_number": "601-428-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "32831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.