Individual provider Active NPI

Angela Marie Martinek, O.D.

  • Optometrist
  • Greensboro, NC
National Provider Identifier
1215088125
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1622 Issued in NC
Practice address
3610 N Elm St
Suite a
Greensboro, NC 27455-2599
Phone
(336) 271-2020
Fax
(336) 275-8200
NPI assigned
Jan 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1622 NC Primary

Addresses

Primary practice location

3610 N Elm St
Suite a
Greensboro, NC 27455-2599

Mailing address

3610 N Elm St
Suite a
Greensboro, NC 27455-2599
Phone (336) 271-2020

Other identifiers 1

IdentifierTypeStateIssuer
890926UMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000898 NC Practitioner - Optometry 0446150643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Eye Center OD PAGroup PAC ID 8022918226, 5 clinicians

Practice addresses (Care Compare)

1305 Lees Chapel Rd
Suite 101
Greensboro, NC 27455-2883
Phone (336) 271-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1622NCMDClinical Psychologist
NC1622NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Eye Center OD, PA Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Triad Eye Associates of Asheboro OD PA Optometrist Past Accepting new patients
Nova Eye Care OD PA Optometrist PastSince Aug 29, 2016 Accepting new patients

Locations

1305 Lees Chapel Rd
Ste 101
Greensboro, NC 27455
Phone (336) 271-2020

3610 N Elm St
Ste A
Greensboro, NC 27455
Phone (336) 271-2020

2205 Oak Ridge Rd
Ste M
Oak Ridge, NC 27310

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215088125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 N ELM ST",
            "address_2": "SUITE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552599",
            "telephone_number": "336-271-2020",
            "fax_number": "336-275-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 N ELM ST",
            "address_2": "SUITE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552599",
            "telephone_number": "336-271-2020",
            "fax_number": "336-275-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEK",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890926U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.