Organization Active NPI

Martin M Nielsen MD a Med Corp

  • Pulmonary Disease Physician
  • Oceanside, CA
National Provider Identifier
1205860491
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G25528 Issued in CA
Legal business name
MARTIN M NIELSEN MD A MED CORP
Practice address
3231 Waring CT Ste L
Oceanside, CA 92056-4510
Phone
(760) 758-7474
Fax
(760) 758-7362
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Martin M. Nielsen, M.D.
Title
President
Phone
(760) 758-7474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X G25528 CA Primary

Addresses

Primary practice location

3231 Waring CT Ste L
Oceanside, CA 92056-4510

Mailing address

3231 Waring CT Ste L
Oceanside, CA 92056-4510
Phone (760) 758-7474

Other identifiers 2

IdentifierTypeStateIssuer
00G255280MedicaidCA
00G255280OtherCABLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1205860491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 WARING CT STE L",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564510",
            "telephone_number": "760-758-7474",
            "fax_number": "760-758-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 WARING CT STE L",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564510",
            "telephone_number": "760-758-7474",
            "fax_number": "760-758-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN M NIELSEN MD A MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-758-7474",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G25528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G255280",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G255280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.