NPIMap

Individual provider Active NPI

Michael James Martin Jr., MD.

  • Family Medicine Physician
  • Millersport, OH
National Provider Identifier
1083662951
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-07-1374 Issued in OH
Practice address
12135 Lancaster St.
Millersport, OH 43046-0218
Phone
(740) 467-2787
Fax
(740) 467-2450
NPI assigned
May 4, 2006
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-07-1374 OH Primary

Addresses

Primary practice location

12135 Lancaster St.
Millersport, OH 43046-0218

Mailing address

PO Box 218
Millersport, OH 43046-0218
Phone (740) 467-2787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101104000089 OH Practitioner - Family Practice 3476747387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

Practice addresses (Care Compare)

12135 Lancaster St
Millersport, OH 43046-8063
Phone (740) 689-4935

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.95 of 100Reported as group
Quality
43.39
Promoting interoperability
100
Improvement activities
40
Cost
76.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals Inc CurrentSince Sep 25, 2022 Accepting new patients
Fairfield Healthcare Professionals, Inc. CurrentSince Sep 25, 2022 Accepting new patients
Fairfield Healthcare Professionals, Inc. Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company 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

Organizations & group practices 4

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 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1083662951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430460218",
            "telephone_number": "740-467-2787",
            "fax_number": "740-467-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12135 LANCASTER ST.",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430460218",
            "telephone_number": "740-467-2787",
            "fax_number": "740-467-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-07-1374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersport, OH

Sources for this page

Verify at the official NPI Registry.