NPIMap

Individual provider Active NPI

Robert A Martello, DO

  • Family Medicine Physician
  • Mount Dora, FL
National Provider Identifier
1205879236
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS7122 Issued in FL
Practice address
3619 Lake Center Dr
Mount Dora, FL 32757-2364
Phone
(352) 383-8222
NPI assigned
Jun 14, 2006
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS7122 FL Primary

Addresses

Primary practice location

3619 Lake Center Dr
Mount Dora, FL 32757-2364

Mailing address

3619 Lake Center Dr
Mount Dora, FL 32757-2364
Phone (352) 383-8222

Other identifiers 3

IdentifierTypeStateIssuer
57335OtherFLBCBS
080101521OtherRAILROAD MEDICARE
250413800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041026000452 FL Practitioner - Family Practice 1254392855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adult Medicine of Lake County IncGroup PAC ID 3173624467, 3 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

3619 Lake Ctr Dr
Mount Dora, FL 32757-2364
Phone (352) 383-8222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Medicine of Lake County Inc CurrentSince Apr 4, 2022 Accepting new patients
Elite Imaging LLC PastSince Apr 3, 2022 Accepting new patients
Wallace Health, LLC PastSince Jan 31, 2021 Accepting new patients

Locations

3619 Lake Center Dr
Mount Dora, FL 32757
Phone (352) 383-8222

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEJFAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JEJFAA/Endpoint/JEJFAA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1205879236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 LAKE CENTER DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572364",
            "telephone_number": "352-383-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 LAKE CENTER DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572364",
            "telephone_number": "352-383-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELLO",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57335",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080101521",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250413800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.