Stanley Michael Martin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5180T Issued in CA

Practice address

1011 Sylvan Ave
Modesto, CA 95350-1692

Phone

(209) 575-2020

Fax

(209) 758-5693

NPI assigned

Oct 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: martin.stanley.p1@direct.castle.nextgenshare.com

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.

• Fifth Optometric Care of California

  • Optometrist
  • San Jose, CA
  • NPI 1215627914
  Medicare reassignment NPD
• Sylvan Eye Associates, a Medical Corporation

  • Ophthalmology Physician
  • Modesto, CA
  • NPI 1740279207

  Optometrist

  Medicare reassignment NPD
• Fifth Optometric Care of California

  • Optometrist
  • Taft, CA
  • NPI 1699504746
  NPD
• Sylvan Eye Associates

  • Ophthalmology Physician
  • Modesto, CA
  • NPI 1487839379
  NPD

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1093704264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501692",
            "telephone_number": "209-575-2020",
            "fax_number": "209-758-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501692",
            "telephone_number": "209-575-2020",
            "fax_number": "209-758-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STANLEY",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5180T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410043677",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0051800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Marie Martin
• Olivia Assunta Martin
• Paula Jean Martin, ASW 118991
• Sasha Bernadette Martin
• Sonia Dagnino Martin
• Taliah Martin
• Tracie Martin
• Alexis Martine
• Lauren Martinez Cruz
• Monique Martinez Feliciano

• Optometrist in Modesto, CA
• Providers in Modesto, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.