Individual provider Active NPI

Lee A Martin Jr., M.D.

  • Diagnostic Radiology Physician
  • Gainesville, GA
National Provider Identifier
1093763385
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
027606 Issued in GA
Practice address
200 W Academy Street
Gainesville, GA 30501
Phone
(770) 282-8820
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 027606 GA Primary

Addresses

Primary practice location

200 W Academy Street
Gainesville, GA 30501

Mailing address

PO Box 2417
Gainesville, GA 30503-2417
Phone (770) 532-9936

Other practice location 1

1250 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3871
Phone (770) 532-9936

Other identifiers 2

IdentifierTypeStateIssuer
000331713EMedicaidGA
00331713AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110621000061 GA Practitioner - Diagnostic RadiologyPractitioner - Interventional RadiologyPractitioner - Nuclear Medicine 3678751716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology, Nuclear Medicine
Education
Medical College of Georgia School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gainesville Radiology Group PCGroup PAC ID 9335046382, 65 clinicians

Practice addresses (Care Compare)

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 535-3553

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Union General Hospital Hospital, Blairsville, GA, CCN 110051

Merit-based Incentive Payment System (MIPS)

Final score
43.55 of 100Reported as group
Quality
36.83
Improvement activities
20
Cost
52.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Radiology Group, PC Diagnostic Radiology CurrentSince Jun 1, 1982 Accepting new patients
Northeast Georgia Medical Center, Inc. Past Accepting new patients

Locations

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

3425 Buford Dr
Ste 100
Buford, GA 30519
Phone (678) 765-6060

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

108 Prominence Ct
Ste 120
Dawsonville, GA 30534
Phone (706) 344-6944

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

3137 Frontage Rd
Gainesville, GA 30504
Phone (770) 219-0500

1250 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501
Phone (770) 531-2444

535 Jesse Jewell Pkwy SE
Ste A
Gainesville, GA 30501
Phone (770) 534-9729

200 W Academy St NW
Gainesville, GA 30501
Phone (770) 800-0041

316 N Broad St
Winder, GA 30680
Phone (770) 307-5354

316 N Broad St
Ste 230
Winder, GA 30680

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.

Hospital & facility affiliations 4

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1093763385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2417",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305032417",
            "telephone_number": "770-532-9936",
            "fax_number": "770-534-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ACADEMY STREET",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-282-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Jesse Jewell Pkwy SE",
            "address_2": "SUITE 500",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013871",
            "country_code": "US",
            "telephone_number": "770-532-9936",
            "fax_number": "770-534-9877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LEE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "027606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000331713E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00331713A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.