Michael James Martin Jr., MD.
Individual provider Active NPI Family Medicine Physician · Millersport, OH
NPI 1083662951 · NPPES record last updated Sep 30, 2013
Key facts
- NPI
- 1083662951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35-07-1374 (OH)
- Practice address
- 12135 Lancaster St.
Millersport, OH 43046-0218 - Phone
- (740) 467-2787
- Fax
- (740) 467-2450
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Northeastern Ohio University College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Fairfield Healthcare Professionals Inc
Practice addresses (Care Compare)
12135 Lancaster St
Millersport, OH 43046-8063
Phone (740) 689-4935
Hospital & facility affiliations
- Summit Orthopaedic Home Care
- Caretenders Vna
- Fairfield Medical Center
- Licking Memorial Hospital
- Grant Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.95 of 100
- Quality
- 43.39
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.51
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101104000089 | OH | Practitioner - Family Practice | 3476747387 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield Healthcare Professionals, Inc. | Current |
Accepting new patients | |
| Fairfield Healthcare Professionals Inc | Current |
Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Fairfield Healthcare Professionals, Inc. | Family Medicine | Past | Accepting new patients |
Locations
131 N Ewing St
Ste C
Lancaster, OH 43130
Phone (740) 689-6600
401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-07-1374 | OH | Yes |
Addresses
Primary practice location
12135 Lancaster St.
Millersport, OH 43046-0218
Mailing address
PO Box 218
Millersport, OH 43046-0218
Phone (740) 467-2787
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077738 | Medicaid | OH |
Other providers in Millersport, OH
- Haga Corporation
- Holly Brianne Hite
- Keller Family Chiropractic, LLC
- Anton Leroy Keller
- Glen E Keller
- Nicole Renee Miller
- Evan Myers
- Jane H Perkins
- Wendy Jo Rinehart
- Melisa Lee Romine
All providers in Millersport, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2013. 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.
- Order and Referring (CMS).
- 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.