NPIMap

Individual provider Active NPI

Martin Irwin Bronk, MD

  • Surgery Physician
  • Menlo Park, CA
National Provider Identifier
1083678726
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G42455 Issued in CA
Practice address
1300 Crane Street
Menlo Park, CA 94025
Phone
(650) 498-6500
Fax
(650) 322-1329
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G42455 CA Primary

Addresses

Primary practice location

1300 Crane Street
Menlo Park, CA 94025

Mailing address

PO Box 60000 File 72484
San Francisco, CA 94160
Phone (650) 498-6500

Other practice location 1

300 Pasteur Dr
Palo Alto, CA 94304-2203
Phone (650) 723-4000

Other identifiers 1

IdentifierTypeStateIssuer
MMM00087MOtherNHIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081229000038 CA Practitioner - General SurgeryPractitioner - General Practice 6002713831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Stanford University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

1300 Crane St
Menlo Park, CA 94025-4260
Phone (650) 498-6500

300 Pasteur Dr
Stanford, CA 94305-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)26
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42455CAMDProsthodontist
G42455CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care Surgery CurrentSince Feb 25, 2015 Accepting new patients
Stanford Health Care CurrentSince Feb 25, 2015 Accepting new patients
University Healthcare Alliance Surgery CurrentSince Oct 31, 1983 Accepting new patients
Affinity Medical Group Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Sequoia Health Services Past Accepting new patients

Locations

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

300 Pasteur Dr
Palo Alto, CA 94304
Phone (650) 723-6469

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: mbronk39313@direct.stanfordhealthcare.org

Organizations & group practices 6

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 7

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1083678726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60000 FILE 72484",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94160",
            "telephone_number": "650-498-6500",
            "fax_number": "650-322-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CRANE STREET",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-498-6500",
            "fax_number": "650-322-1329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943042203",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONK",
        "first_name": "MARTIN",
        "middle_name": "IRWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G42455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHIC",
            "identifier": "MMM00087M",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.