Individual provider Active NPI

Elliott Burton Martin Jr., M.D.

  • Psychiatry Physician
  • West Roxbury, MA
National Provider Identifier
1073741617
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
250690 Issued in MA
Practice address
60 Perham St
West Roxbury, MA 02132-3254
Phone
(617) 429-6997
Fax
(617) 243-6486
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 250690 MA Primary

Addresses

Primary practice location

60 Perham St
West Roxbury, MA 02132-3254

Mailing address

60 Perham St
West Roxbury, MA 02132-3254
Phone (617) 429-6997

Other practice location 1

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 624-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121126000216 MA Practitioner - Psychiatry 3971754953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250690MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Nov 19, 2012 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients

Locations

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

Interoperability endpoints

  • Direct secure messaging: martin.elliott.nwh@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1073741617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PERHAM ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021323254",
            "telephone_number": "617-429-6997",
            "fax_number": "617-243-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PERHAM ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021323254",
            "telephone_number": "617-429-6997",
            "fax_number": "617-243-6486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021902432",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ELLIOTT",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "250690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

Verify at the official NPI Registry.