Individual provider Active NPI

Thomas O Martin, MD

  • General Practice Physician
  • Lincoln, NE
National Provider Identifier
1174625875
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14840 Issued in NE
Practice address
5000 N 26TH St
Ste 300
Lincoln, NE 68521-4749
Phone
(402) 435-2060
Fax
(402) 435-2046
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14840 NE Primary

Addresses

Primary practice location

5000 N 26TH St
Ste 300
Lincoln, NE 68521-4749

Mailing address

8055 O St
Ste 300
Lincoln, NE 68510-2580
Phone (402) 421-0896

Other identifiers 2

IdentifierTypeStateIssuer
4024OtherNEMIDLAND'S CHOICE
35349OtherNEBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20091214000238 NE Practitioner - Family Practice 1052451622 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Family Medical Group PC CurrentSince May 1, 2018 Accepting new patients
The Physician Network Past Accepting new patients

Locations

7441 O St
Ste 300
Lincoln, NE 68510
Phone (402) 483-6575

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1174625875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST",
            "address_2": "STE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102580",
            "telephone_number": "402-421-0896",
            "fax_number": "402-421-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 N 26TH ST",
            "address_2": "STE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214749",
            "telephone_number": "402-435-2060",
            "fax_number": "402-435-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "THOMAS",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "14840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "4024",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35349",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.