Individual provider Active NPI

Christina Mary Martin, M.D.

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1104168855
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME122319 Issued in FL
Practice address
3515 E Fletcher Ave
Tampa, FL 33613-4706
Phone
(813) 974-2201
NPI assigned
Mar 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME122319 FL Primary

Addresses

Primary practice location

3515 E Fletcher Ave
Tampa, FL 33613-4706

Mailing address

4866 Pond Ridge Dr
Riverview, FL 33578-2105
Phone (863) 838-2838

Other practice location 1

12901 Bruce B Downs Blvd
MDC 41
Tampa, FL 33612-4742
Phone (813) 844-7412

Other practice location 2

510 Vonderburg Dr Ste 301
Brandon, FL 33511
Phone (813) 881-1000

Other identifiers 2

IdentifierTypeStateIssuer
101087200MedicaidFL
LA574OtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmartin71051@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200124002309 FL Practitioner - Psychiatry 8820423619 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME122319FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Nov 19, 2019 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc Psychiatry CurrentSince Nov 19, 2019 Accepting new patients
Tampa General Hospital Current Accepting new patients
Phoenix Programs of Florida, Inc. Past Accepting new patients

Locations

3515 E Fletcher Ave
Tampa, FL 33613
Phone (813) 974-2748

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Interoperability endpoints

  • Direct secure messaging: cmartin71051@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1104168855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4866 POND RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782105",
            "telephone_number": "863-838-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134706",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 Bruce B Downs Blvd",
            "address_2": "MDC 41",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124742",
            "country_code": "US",
            "telephone_number": "813-844-7412",
            "fax_number": "813-974-8359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 Vonderburg Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "33511",
            "country_code": "US",
            "telephone_number": "813-881-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTINA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME122319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101087200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "LA574",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmartin71051@direct.tgh.org",
            "affiliation": "N",
            "address_1": "3515 E Fletcher Ave",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336134706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.