Individual provider Active NPI

John A Martini, MD

  • Family Medicine Physician
  • Pleasant Prairie, WI
National Provider Identifier
1033119276
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25991 Issued in WI
Practice address
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone
(262) 671-7050
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25991 WI Primary

Addresses

Primary practice location

9555 76TH St
Pleasant Prairie, WI 53158-1984

Mailing address

111 E Wisconsin Ave
Milwaukee, WI 53202-4815
Phone (414) 290-6700

Other identifiers 1

IdentifierTypeStateIssuer
30593800MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmartini347658@direct.froedtert.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20041115000523 WI Practitioner - Family PracticePractitioner - Hospitalist 0143284703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Medical College of Wisconsin, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 653-5300

Hospital & facility affiliations

  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue163
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Wisconsin HM SC CurrentSince Aug 15, 2023 Accepting new patients
Froedtert South, Inc. Family Medicine CurrentSince Oct 21, 2022 Accepting new patients
Mercy Health System Corporation PastSince Jan 17, 2022 Accepting new patients
Froedtert South, Inc. Past Accepting new patients
Health Dynamics, LLC PastSince Jan 17, 2022 Accepting new patients
Aggeus Healthcare, P.C. Past Accepting new patients
Ihc-Libertyville Emergency Physicians, LLC Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

8633 32nd Ave
Kenosha, WI 53142
Phone (262) 694-8300

10105 74th St
Ste 101
Kenosha, WI 53142
Phone (262) 697-5056

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

7322 236th Ave
Salem, WI 53168
Phone (262) 577-8460

Interoperability endpoints

  • Direct secure messaging: jmartini347658@direct.froedtert.com

Organizations & group practices 7

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1033119276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-671-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30593800",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmartini347658@direct.froedtert.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6308 8th Ave",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531435031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.