Individual provider Active NPI

Daniel Martinez Coconubo, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Portsmouth, NH
National Provider Identifier
1144719931
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
23565 Issued in NH
Practice address
333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone
(603) 559-4131
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 23565 NH Primary

Addresses

Primary practice location

333 Borthwick Ave
Portsmouth, NH 03801-7128

Mailing address

333 Borthwick Ave
Portsmouth, NH 03801-7128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20230711000763 NH Practitioner - Pathology 0446633267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forward Pathology Solutions - New Hampshire LLCGroup PAC ID 3274950266, 5 clinicians

Practice addresses (Care Compare)

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 433-4907

Hospital & facility affiliations

  • Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029
  • Parkland Medical Center Hospital, Derry, NH, CCN 300017
  • Frisbie Memorial Hospital Hospital, Rochester, NH, CCN 300014
  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • York Hospital Hospital, York, ME, CCN 200020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23565NHMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Pathology Solutions - New Hampshire, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 17, 2023 Accepting new patients
Pathways Professional Association Anatomic Pathology & Clinical Pathology CurrentSince Aug 15, 2026 Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

11 Whitehall Rd
Rochester, NH 03867
Phone (603) 330-7905

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1144719931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128",
            "telephone_number": "603-559-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ COCONUBO",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NH",
            "license": "23565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.