NPIMap

Individual provider Active NPI

Jason Robert Martin, M.D.

  • Dermatology Physician
  • Crestview Hills, KY
National Provider Identifier
1235549205
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
53911 Issued in KY
Practice address
651 Centre View Blvd
Crestview Hills, KY 41017-5423
Phone
(859) 371-3376
Fax
(859) 331-1053
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35-134208 OH
Dermatology Physician 207N00000X 53911 KY Primary

Addresses

Primary practice location

651 Centre View Blvd
Crestview Hills, KY 41017-5423

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 371-3376

Other identifiers 1

IdentifierTypeStateIssuer
0311385MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180827000149 OH Practitioner - Dermatology 5193943934 Reassigns benefits to 1 organization
I20200730000181 KY Practitioner - Dermatology 5193943934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

651 Centre View Boulvard
Crestview Hills, KY 41017-5419
Phone (859) 331-6466

Hospital & facility affiliations

  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision30
Removal of skin lesions887
Skin biopsy179

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Sep 28, 2020 Accepting new patients
Summit Medical Group, Inc Dermatology CurrentSince Sep 28, 2020 Accepting new patients
The Dermatology Group, Inc Dermatology CurrentSince Sep 1, 2018 Accepting new patients

Locations

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

5298 Socialville Foster Rd
Mason, OH 45040
Phone (513) 770-0953

Interoperability endpoints

  • Direct secure messaging: jmartin330246@direct-prd.stelizabeth.com
  • FHIR API: https://api.platform.athenahealth.com/5662/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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 1

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1235549205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-371-3376",
            "fax_number": "859-331-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175423",
            "telephone_number": "859-371-3376",
            "fax_number": "859-331-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35-134208",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "53911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0311385",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.