Individual provider Active NPI

Craig Randall Martin, M.D.

  • Cardiovascular Disease Physician
  • Riverview, FL
National Provider Identifier
1144509860
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME42666 Issued in FL
Practice address
13403 Boyette Rd
Riverview, FL 33569-8742
Phone
(813) 654-1775
Fax
(813) 651-9082
NPI assigned
Aug 11, 2011
Last updated
Aug 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME42666 FL Primary

Addresses

Primary practice location

13403 Boyette Rd
Riverview, FL 33569-8742

Mailing address

13403 Boyette Rd
Riverview, FL 33569-8742
Phone (813) 654-1775

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
I20110901000591 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0547213456 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME42666FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc CurrentSince Sep 23, 2019 Accepting new patients

Locations

13403 Boyette Rd
Riverview, FL 33569
Phone (813) 530-0520

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1144509860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13403 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698742",
            "telephone_number": "813-654-1775",
            "fax_number": "813-651-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13403 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698742",
            "telephone_number": "813-654-1775",
            "fax_number": "813-651-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CRAIG",
        "middle_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME42666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.