Individual provider Active NPI

Alan Martin, M.D.

  • Rheumatology Physician
  • Tulsa, OK
National Provider Identifier
1083677017
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
17339 Issued in OK
Practice address
4812 S 109TH East Ave
Ste. 200
Tulsa, OK 74146-5822
Phone
(918) 236-4567
Fax
(918) 236-4578
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 17339 OK Primary

Addresses

Primary practice location

4812 S 109TH East Ave
Ste. 200
Tulsa, OK 74146-5822

Mailing address

4812 S 109TH East Ave
Ste. 200
Tulsa, OK 74146-5822
Phone (918) 236-4567

Other identifiers 1

IdentifierTypeStateIssuer
100128830AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20070824000407 OK Practitioner - Rheumatology 7416049226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Oklahoma College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

4812 S 109TH E Ave
Tulsa, OK 74146-5826
Phone (918) 392-1513

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
61.03
Promoting interoperability
99
Improvement activities
40
Cost
77.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17399OKMDPharmacist
17339OKMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Bone & Joint Associates PC Rheumatology CurrentSince Sep 1, 2007 Accepting new patients
Osu Health System Anesthesia Past Accepting new patients

Locations

4802 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

4812 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1482

4812 S 109th East Ave
Ste 200
Tulsa, OK 74146
Phone (918) 236-4567

Interoperability endpoints

  • Direct secure messaging: alan.martin@tbja.gwaydirect.com
  • Direct secure messaging: amartin50728@direct.saintfrancis.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1601

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1083677017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 S 109TH EAST AVE",
            "address_2": "STE. 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-236-4567",
            "fax_number": "918-236-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 S 109TH EAST AVE",
            "address_2": "STE. 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-236-4567",
            "fax_number": "918-236-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OK",
            "license": "17339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100128830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.