Individual provider Active NPI

David Nicholas Martino, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1235410846
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2268151 Issued in MA
Practice address
100 Cambridge St FL 14
Boston, MA 02114-2509
Phone
(617) 383-9745
Fax
(617) 344-9703
NPI assigned
Sep 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2268151 MA Primary

Addresses

Primary practice location

100 Cambridge St FL 14
Boston, MA 02114-2509

Mailing address

1 Laurel Path
Norfolk, MA 02056-1062
Phone (617) 945-6931

Other names 1

  • Ms. Amanda Elisabeth Martino Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121114000284 MA Practitioner - Nurse Practitioner 6800047184 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2268151MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Neurobehavioral Associates, LLC CurrentSince Jun 12, 2019 Accepting new patients
Child & Family Services, Inc. CurrentSince Jun 24, 2019 Accepting new patients

Locations

3057 Acushnet Ave
New Bedford, MA 02745
Phone (508) 742-1040

965 Church St
New Bedford, MA 02745
Phone (508) 996-3154

226 Field St
New Bedford, MA 02740
Phone (508) 817-5129

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1235410846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAUREL PATH",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "020561062",
            "telephone_number": "617-945-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "617-383-9745",
            "fax_number": "617-344-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "DAVID",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2268151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MARTINO",
            "middle_name": "ELISABETH",
            "prefix": "MS.",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.