Samuel I Martisius, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101018393 Issued in MI

Practice address

13355 E 10 Mile Rd
Warren, MI 48089-2048

Phone

(586) 759-7690

NPI assigned

Jul 21, 2009

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 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

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 2

Specialty

Emergency Medicine

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Redwood Medical Group IncGroup PAC ID 5496652703, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325

Merit-based Incentive Payment System (MIPS)

Final score

80.98 of 100Reported as group

Quality

73.31

Promoting interoperability

92

Improvement activities

40

Cost

62

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.76

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AECBBA
• Direct secure messaging: samuel.martisius@812592636035076.direct.elationemr.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.

• Pacific Redwood Medical Group Inc

  • Emergency Medicine Physician
  • Ukiah, CA
  • NPI 1033103676
  Medicare reassignment Care Compare group NPD
• Long Valley Health Center

  • Clinic/Center
  • Laytonville, CA
  • NPI 1366467375
  Medicare reassignment NPD
• Round Valley Indian Health Center, Inc.

  • Clinic/Center
  • Covelo, CA
  • NPI 1669532750
  Medicare reassignment NPD
• Round Valley Indian Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covelo, CA
  • NPI 1114136066
  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health Mendocino Coast

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Care Compare affiliation

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1043440308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13355 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "586-759-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "586-759-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTISIUS",
        "first_name": "SAMUEL",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101018393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5101018393",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louise Evelyn Martin, M.D.
• Rachelle Trono Martin, PHARMD
• Stephanie Martin, LCSW
• Tiffany Martin
• Elisabeth Martines
• Angelie T Martzke, LMSW
• Mary Wlodyga Frye DC
• Masar Transportation
• Brooklynn S Masco
• Bernadette Joy Mason, FNP-BC

• Emergency Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.