Individual provider Active NPI

Sharel A Martin, MD

  • Emergency Medicine Physician
  • Tomah, WI
National Provider Identifier
1114917648
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
37339-20 Issued in WI
Practice address
325 Butts Ave
Tomah, WI 54660-1412
Phone
(608) 372-5951
Fax
(608) 372-3436
NPI assigned
Oct 26, 2005
Last updated
Apr 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37339-20 WI Primary
Family Medicine Physician 207Q00000X 37339 WI

Addresses

Primary practice location

325 Butts Ave
Tomah, WI 54660-1412

Mailing address

325 Butts Ave
Tomah, WI 54660-1412
Phone (608) 372-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20150310000504 WI Practitioner - Family Practice 1557687597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tomah Memorial Hospital IncGroup PAC ID 6901897016, shared by 4 NPIs, 54 clinicians

Practice addresses (Care Compare)

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37339-20WIMDEmergency Medicine Physician
37339WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomah Memorial Hospital Inc Current Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Tomah Memorial Hospital Inc Emergency Medicine CurrentSince Jan 1, 2015 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. Past Accepting new patients

Locations

321 Butts Ave
Tomah, WI 54660
Phone (608) 372-2181

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

Interoperability endpoints

  • Direct secure messaging: smartin60868@direct.emplifyhealth.org

Organizations & group practices 4

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 1

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1114917648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 BUTTS AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601412",
            "telephone_number": "608-372-5951",
            "fax_number": "608-372-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 BUTTS AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601412",
            "telephone_number": "608-372-5951",
            "fax_number": "608-372-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHAREL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "37339-20",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.