Individual provider Active NPI

Tara Kay Martin, MD

  • Emergency Medicine Physician
  • Renton, WA
National Provider Identifier
1104054543
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60361936 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(425) 228-3440
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD60361936 WA Primary

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

25246 Network PL
Chicago, IL 60673-1252
Phone (425) 656-4255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20130611000348 WA Practitioner - Emergency Medicine 3072752658 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albany Medical College of Union University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Emergency Room Physicians Inc PSGroup PAC ID 7911892054, 28 clinicians

Practice addresses (Care Compare)

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3440

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.2
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60361936WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Puget Sound Physicians PLLC Emergency Medicine CurrentSince Dec 3, 2013 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2014 Accepting new patients
Associated Emergency Room Physicians, Inc P.S. Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients

Locations

25246 Network Pl
Chicago, IL 60673

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

3011 196th St SW
Lynnwood, WA 98036
Phone (425) 688-5759

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 3

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 2

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1104054543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25246 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731252",
            "telephone_number": "425-656-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TARA",
        "middle_name": "KAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60361936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.