Individual provider Active NPI

Deirbhile Martin, MD

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1184308785
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MT228132 Issued in PA
Practice address
1100 Walnut St
Philadelphia, PA 19107-5563
Phone
(215) 955-8666
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT228132 PA Primary

Addresses

Primary practice location

1100 Walnut St
Philadelphia, PA 19107-5563

Mailing address

221 S 12TH St Apt N304
Philadelphia, PA 19107-5553
Phone (617) 455-1842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230628003535 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 5496114100

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1184308785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 12TH ST APT N304",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075553",
            "telephone_number": "617-455-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075563",
            "telephone_number": "215-955-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DEIRBHILE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT228132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.