NPIMap

Individual provider Active NPI

Martin Kade Hardy, D.O.

  • Surgery Physician
  • Augusta, GA
National Provider Identifier
1063897379
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
84672 Issued in GA
Practice address
3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
Jul 28, 2015
Last updated
May 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS18036 FL
Surgery Physician 208600000X 2016036475 MO
Surgery Physician 208600000X DO83399 SC
Surgery Physician 208600000X 84672 GA Primary

Addresses

Primary practice location

3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868

Mailing address

PO Box 3726
Augusta, GA 30914-3726
Phone (706) 863-9595

Other practice location 1

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 863-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200812003809 GA Practitioner - General Surgery 3678999240 Reassigns benefits to 1 organization
I20210517001021 SC Practitioner - General Surgery 3678999240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
William Carey University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph M Still Burn Centers, IncGroup PAC ID 7618963638, 47 clinicians

Practice addresses (Care Compare)

3675 J Dewey Gray Cir
Augusta, GA 30909-1868
Phone (706) 863-9595

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue82
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016036475MOMDSurgery Physician
DO83399SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph M Still Burn Centers, Inc Past Accepting new patients
Doctors Hospital of Augusta LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1063897379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR STE 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3651 Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096521",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDY",
        "first_name": "MARTIN",
        "middle_name": "KADE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS18036",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2016036475",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "DO83399",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "84672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.