Individual provider Active NPI

Martha Ellen Corcoran, M.D.

  • Otolaryngology Physician
  • Fairfield, CA
National Provider Identifier
1063487825
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G064295 Issued in CA
Practice address
2702 Low CT
Fairfield, CA 94534-9771
Phone
(707) 427-4900
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G064295 CA Primary

Addresses

Primary practice location

2702 Low CT
Fairfield, CA 94534-9771

Mailing address

10470 Old Placerville Rd
#100
Sacramento, CA 95827-2539
Phone (866) 681-0736

Other identifiers 1

IdentifierTypeStateIssuer
00G642950MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20091027000248 CA Practitioner - Otolaryngology 1951448885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600

2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G064295CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Otolaryngology CurrentSince Nov 1, 2009 Accepting new patients
Sutter Valley Medical Foundation Otolaryngology Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Contra Costa County Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

2702 Low Ct
Fairfield, CA 94534
Phone (707) 432-2600

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

Interoperability endpoints

  • Direct secure messaging: mcorcoran50233@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 3

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1063487825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "#100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "866-681-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 LOW CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349771",
            "telephone_number": "707-427-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "MARTHA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G064295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G642950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.