Bruce D Martin, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L8824 Issued in TX

Practice address

12461 Timberland Blvd
Suite 309
Fort Worth, TX 76244-5213

Phone

(817) 741-5437

Fax

(817) 977-5439

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: alliancepeds@allp.ssdirect.aprima.com
• Direct secure messaging: bmartin24889@cookchildrens.direct-ci.com

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.

• Alliance Primary Care Assoc PLLC

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1912260506
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1043390974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12461 TIMBERLAND BLVD",
            "address_2": "SUITE 309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-741-5437",
            "fax_number": "888-400-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12461 TIMBERLAND BLVD",
            "address_2": "SUITE 309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445213",
            "telephone_number": "817-741-5437",
            "fax_number": "817-977-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRUCE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L8824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GRP PIN",
            "identifier": "00U87Z",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165586203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCHIP PIN",
            "identifier": "MARBI09084",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX PIN",
            "identifier": "8A5662",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PIN",
            "identifier": "2619123",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1881820595",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7340635",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205573301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BQ027",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonio Eduardo Martin, M.D.
• Baqi S. Martin, LCSW
• Barbara Dale Martin, RN
• Bonnie Ruth Martin, ANP
• Britney Martin, PA
• Catherine M Martin, NP
• Courtney Martin, OTR, MOT
• Courtney Martin, PSYD
• Crystal Rachell Martin
• Dana M Martin, PT

• Pediatrics Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.