Mary Wade Martin, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

23664 Issued in OK

Practice address

3610 Stagg Dr
Beaumont, TX 77701-3713

Phone

(409) 923-0012

Fax

(409) 291-8010

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Obstetrics/GynecologyAlso: Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Foundation IncGroup PAC ID 5597153221, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mawade@direct.uspi.com

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.

• Texas Health Foundation, Inc

  • Obstetrics & Gynecology Physician
  • Beaumont, TX
  • NPI 1992473391

  Obstetrics & Gynecology, TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1245244359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 STAGG DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013713",
            "telephone_number": "409-923-0012",
            "fax_number": "409-291-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 STAGG DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013713",
            "telephone_number": "409-923-0012",
            "fax_number": "409-291-8010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2610 NW Expressway",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731127277",
            "country_code": "US",
            "telephone_number": "405-307-6668 x501",
            "fax_number": "405-701-6170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 S Mill St",
            "address_purpose": "LOCATION",
            "city": "Pryor",
            "state": "OK",
            "postal_code": "743615221",
            "country_code": "US",
            "telephone_number": "918-825-3777",
            "fax_number": "918-825-3776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARY",
        "middle_name": "WADE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23664",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "23664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braylon Josephlee Martin
• Cristina Michelle Martin, RN, MSN, FNP-C
• Haley Martin
• Jacqueline Martin, R. N.
• Maggy Martin
• Pamela A Martin, PTA
• Romona Martin
• Taylor Martin
• Noemi Martinez Galvan
• Audrey Martinez, FNP

• All providers in Beaumont, TX
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.