Active NPI
Thomas David Martin, M.D.
- Surgery Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301094619
- Practice address
- 1900 Wealthy St SE
Suite 180
Grand Rapids, MI 49506-2969 - Phone
- (616) 774-8501
- Fax
- (616) 774-8595
- NPI assigned
- Apr 1, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301094619 | MI | Primary |
Addresses
Primary practice location
1900 Wealthy St SE
Suite 180
Grand Rapids, MI 49506-2969
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tmartin112007@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Wayne State University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000
1900 Wealthy St SE
180 Corewell Health Medical Group West
Grand Rapids, MI 49506-2972
Phone (616) 774-8501
2009 Holton Rd
Muskegon, MI 49445-1578
Phone (231) 291-8399
2249 Wealthy St SE
110 Corewell Health Medical Group West
East Grand Rapids, MI 49506-3055
Phone (616) 391-4600
230 W Oak St
Fremont, MI 49412-1526
4069 Lake Dr SE
Grand Rapids, MI 49546-8816
4100 Lake Dr SE
Grand Rapids, MI 49546-8292
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
8333 Felch St
Zeeland, MI 49464-2608
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301094619 | MI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Spectrum Health Hospitals | Current | Accepting new patients | |
| Spectrum Health Hospitals | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients |
Locations
230 W Oak St
Ste 101
Fremont, MI 49412
Phone (616) 267-7400
1900 Wealthy St SE
Ste 180
Grand Rapids, MI 49506
Phone (616) 458-1200
4069 Lake Dr SE
Ste 117
Grand Rapids, MI 49546
Phone (616) 267-8600
221 Michigan St NE
Ste 300
Grand Rapids, MI 49503
Phone (616) 459-7258
275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900
221 Michigan St NE
Ste 406
Grand Rapids, MI 49503
Phone (616) 391-5701
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
4100 Lake Dr SE
Ste 301
Grand Rapids, MI 49546
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
2009 Holton Rd
North Muskegon, MI 49445
Phone (231) 291-8020
8333 Felch St
Ste 300
Zeeland, MI 49464
Phone (616) 267-9823
Interoperability endpoints
- tmartin112007@epic00.corewelldirect.org
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Hospitalist Physician
- Grand Rapids, MI
- NPI 1558407189
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
-
- Urgent Care Clinic/Center
- Grand Rapids, MI
- NPI 1821422007
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1114169570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 WEALTHY ST SE",
"address_2": "SUITE 180",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495062969",
"telephone_number": "616-774-8501",
"fax_number": "616-774-8595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "THOMAS",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-01",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301094619",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tmartin112007@epic00.shdirect.org",
"affiliation": "N",
"address_1": "1900 Wealthy St SE",
"address_2": "Suite 180",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495062969",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1900 Wealthy St SE",
"address_2": "Suite 180",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495062969",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.