Dale L. Martin, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11009121 Issued in FL

Practice address

1040 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-7809

Phone

(850) 916-8700

NPI assigned

May 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gastroenterology Associates of Pensacola PAGroup PAC ID 2365422664, 40 clinicians

US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.8 of 100Reported as group

Quality

99.47

Improvement activities

40

Cost

83.62

Merit-based Incentive Payment System (MIPS)

Final score

76.51 of 100Reported as group

Quality

51.13

Promoting interoperability

94

Improvement activities

40

Cost

75.56

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Gastroenterology Associates of Pensacola PA

  • Gastroenterology Physician
  • Pensacola, FL
  • NPI 1235223785
  Medicare reassignment Care Compare group NPD
• US Anesthesia Partners of Florida Inc.

  • Anesthesiology Physician
  • Maitland, FL
  • NPI 1518910520

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Gastroenterology Associates of Pensacola PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1861535403
  NPD

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1225398563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7178 BLUE JACK DR",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667304",
            "telephone_number": "601-447-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617809",
            "telephone_number": "850-916-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DALE",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R787462",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11009121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I438792",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3481631",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4017520",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03280005",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9060979",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01109800",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evetha Malcolm-Theriault, RD
• Tiffany Rose Marcum, OTR/L
• Marianne Hazelitt DO Professional Association
• Marshall Mediation & Consultant, Inc.
• Marta Jacenyik LLC
• Julieann N Massa
• Massage by Micah LLC
• Julie Anne Massengale
• Richard Smith Matthews Jr., M.D.
• Weldon Arnold Mauney III, M.D.

• Certified Registered Nurse Anesthetist in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.