Active NPI
John Alan Martinetti, AU.D. CCC
- Audiologist
- Port Jefferson Station, NY
National Provider Identifier
1194718205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 000898
- Practice address
- 5225 Nesconset Hwy
Suite 10
Port Jefferson Station, NY 11776-2053 - Phone
- (631) 331-1888
- Fax
- (631) 331-4724
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 000898 | NY | Primary |
| Speech-Language Pathologist | 235Z00000X | 002232 | NY |
Addresses
Primary practice location
5225 Nesconset Hwy
Suite 10
Port Jefferson Station, NY 11776-2053
Mailing address
5225 Nesconset Hwy
Suite 10
Port Jefferson Station, NY 11776-2053
Phone (631) 331-1888
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014538 | Other | NY | AETNA/US HEALTHCARE |
| 0C4525 | Other | NY | HEALTHNET |
| 125886 | Other | NM | UNITED HEALTHCARE |
| 2814 | Other | NY | VYTRA SPEECH |
| 002232 | Other | NY | HIP SPEECH ID# |
| M04241 | Other | NY | EMPIRE BC/BS |
| 0096400 | Other | NY | AETNA/US HEALTHCARE GROUP |
| 4210876 | Other | NY | AETNA SPEECH ID# |
| 865009 | Other | NY | HIP MEDICAID |
| CS145 | Other | NY | OXFORD |
| 114520 | Other | NY | VYTRA AUDIO |
| 8457760 | Other | NY | AETNA AUDIO |
| 000898 | Other | NY | HIP AUDIO ID# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060712000076 | NY | Practitioner - Qualified Audiologist | 2466465646 | Practice locations: Port Jefferson Station, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5225 Nesconset Hwy
Suite 10
Port Jefferson Station, NY 11776-2054
Phone (631) 331-1888
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000898 | NY | MD | Mental Health Counselor |
| 002232 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1194718205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5225 NESCONSET HWY",
"address_2": "SUITE 10",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117762053",
"telephone_number": "631-331-1888",
"fax_number": "631-331-4724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 NESCONSET HWY",
"address_2": "SUITE 10",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117762053",
"telephone_number": "631-331-1888",
"fax_number": "631-331-4724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINETTI",
"first_name": "JOHN",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "AU.D. CCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "000898",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "002232",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/US HEALTHCARE",
"identifier": "014538",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "0C4525",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "125886",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA SPEECH",
"identifier": "2814",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP SPEECH ID#",
"identifier": "002232",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "M04241",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/US HEALTHCARE GROUP",
"identifier": "0096400",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA SPEECH ID#",
"identifier": "4210876",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP MEDICAID",
"identifier": "865009",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "CS145",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA AUDIO",
"identifier": "114520",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA AUDIO",
"identifier": "8457760",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP AUDIO ID#",
"identifier": "000898",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.