NPIMap

Individual provider Active NPI

David John Martin, M.D.

  • Urology Physician
  • Santa Rosa, CA
National Provider Identifier
1225036320
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A82729 Issued in CA
Practice address
4415 Sonoma Hwy
Suite a
Santa Rosa, CA 95409-7100
Phone
(707) 537-2070
Fax
(707) 537-9696
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A82729 CA Primary

Addresses

Primary practice location

4415 Sonoma Hwy
Suite a
Santa Rosa, CA 95409-7100

Mailing address

4415 Sonoma Hwy
Suite a
Santa Rosa, CA 95409-7100
Phone (707) 537-2070

Other identifiers 2

IdentifierTypeStateIssuer
GR0067920MedicaidCA
P00051386OtherRR MEDICARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20051005000657 CA Practitioner - Urology 4587699822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Loyola University of Chicago, Stritch School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82729CAMDMental Health Counselor
A82729CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo Current Accepting new patients
North Bay Medical Group, Inc. Past Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: dmartin19109@smch.direct-ci.com
  • Direct secure messaging: david_j_martin_md@yourcarecommunity.org

Organizations & group practices 2

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

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1225036320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 SONOMA HWY",
            "address_2": "SUITE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954097100",
            "telephone_number": "707-537-2070",
            "fax_number": "707-537-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 SONOMA HWY",
            "address_2": "SUITE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954097100",
            "telephone_number": "707-537-2070",
            "fax_number": "707-537-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A82729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067920",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARD",
            "identifier": "P00051386",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.