NPIMap

Individual provider Active NPI

Mark A Martindale, M.D.

  • Internal Medicine Physician
  • Benton, AR
National Provider Identifier
1205911849
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C7310 Issued in AR
Practice address
5 Medical Park Dr
Suite 102a
Benton, AR 72015-3729
Phone
(501) 315-1222
Fax
(501) 315-1222
NPI assigned
Oct 25, 2006
Last updated
Jul 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C7310 AR Primary
Pediatrics Physician 208000000X C7310 AR

Addresses

Primary practice location

5 Medical Park Dr
Suite 102a
Benton, AR 72015-3729

Mailing address

105 McNeil St
Suite 102a
Benton, AR 72015-3345
Phone (501) 315-1222

Other identifiers 1

IdentifierTypeStateIssuer
119185001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20040915001000 AR Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6507833357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Arkansas College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saline Med-Peds Group, IncGroup PAC ID 7517934359, 2 clinicians

Practice addresses (Care Compare)

105 McNeil St
Benton, AR 72015-3345
Phone (501) 315-1222

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C7310ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saline Med-Peds Group, Inc Internal Medicine CurrentSince Mar 1, 1999 Accepting new patients
Saline Orthopedic Group P a PastSince Mar 1, 1999 Accepting new patients
Saline Clinics LLC Internal Medicine PastSince Jul 1, 2016 Accepting new patients

Locations

105 McNeil St
Benton, AR 72015
Phone (501) 315-0984

105 McNeil St
Ste 102A
Benton, AR 72015

5 Medical Park Dr
Ste 102A
Benton, AR 72015
Phone (501) 315-1222

Interoperability endpoints

  • Direct secure messaging: admin@salinemedpeds.e-mdsdirect.com
  • FHIR API: https://api.platform.athenahealth.com/16686/brand/1/csg/1/fhir/r4

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 12

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1205911849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MCNEIL ST",
            "address_2": "SUITE 102A",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153345",
            "telephone_number": "501-315-1222",
            "fax_number": "501-315-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DR",
            "address_2": "SUITE 102A",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153729",
            "telephone_number": "501-315-1222",
            "fax_number": "501-315-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINDALE",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C7310",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "C7310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119185001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.