Martin Daniel Godwin, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Medina, NY
NPI 1053489435 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053489435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 349871-1 (NY)
- Practice address
- 534 Main St Ste 14
Medina, NY 14103-1436 - Phone
- (585) 798-3992
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Great Lakes Surgical Associates, P.C.
Niagara Frontier Anesthesia Services LLP
Practice addresses (Care Compare)
160 E Ave
Lockport, NY 14094-3835
Phone (716) 434-6141
200 Ohio St
Medina, NY 14103-1063
Phone (716) 674-8189
Hospital & facility affiliations
- Medina Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111122000012 | NY | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8325212731 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 349871 | NY | MD | Family Nurse Practitioner |
| 349871-1 | NY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Niagara Medical Group PC | Current |
Accepting new patients | |
| Niagara Frontier Anesthesia Services LLP | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Great Lakes Surgical Associates, P.C. | Current |
Accepting new patients |
Locations
127 North St
Batavia, NY 14020
Phone (585) 267-7510
2372 Sweet Home Rd
Ste 3
Buffalo, NY 14228
15 Elizabeth Dr
Lockport, NY 14094
Phone (716) 434-6141
160 East Ave
Lockport, NY 14094
Phone (716) 434-6141
200 Ohio St
Medina, NY 14103
Phone (585) 798-2000
534 Main St
Ste 14
Medina, NY 14103
Phone (585) 798-3992
5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800
4185 Seneca St
Ste 11
West Seneca, NY 14224
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DCBCBA/Endpoint/DCBCBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 349871-1 | NY | Yes |
Addresses
Primary practice location
534 Main St Ste 14
Medina, NY 14103-1436
Mailing address
2902 Coomer Rd
Newfane, NY 14108-9613
Phone (716) 778-0230
Other providers in Medina, NY
- Pamela Foss
- Tania Marie Freeman
- Jodie Ann Fuller
- General Physician Sub I PLLC
- Wagdy Ghaly
- Ruta Gokhale
- Paul R Grout
- Stacie Marie Guild
- Buffie L Haley
- Christine Aleah Halfmann
All providers in Medina, NY · Certified Registered Nurse Anesthetist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.