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Individual provider Active NPI

Matthew Harrison Martell, DO

  • Orthopaedic Trauma Physician
  • Macon, GA
National Provider Identifier
1104269463
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
79422 Issued in GA
Practice address
840 Pine St Ste 500
Macon, GA 31201-7530
Phone
(478) 633-8682
Fax
(478) 633-8698
NPI assigned
Apr 16, 2013
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X 079422 GA
Orthopaedic Trauma Physician 207XX0801X 79422 GA Primary

Addresses

Primary practice location

840 Pine St Ste 500
Macon, GA 31201-7530

Mailing address

840 Pine St Ste 500
Macon, GA 31201-7530
Phone (478) 633-8682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180926001346 GA Practitioner - Orthopedic Surgery 9335490648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

840 Pine St
Macon, GA 31201-7530

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
079422GAMDOrthopaedic Surgery Physician
79422GAMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc CurrentSince Aug 1, 2018 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

840 Pine St
Ste 500
Macon, GA 31201
Phone (478) 633-8060

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • Direct secure messaging: mmartell433281@carolinashealthcaresystem.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1104269463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 500",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017530",
            "telephone_number": "478-633-8682",
            "fax_number": "478-633-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 500",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017530",
            "telephone_number": "478-633-8682",
            "fax_number": "478-633-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELL",
        "first_name": "MATTHEW",
        "middle_name": "HARRISON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "079422",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "GA",
            "license": "79422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.