Individual provider Active NPI

Carolyn J Martin, O.D.

  • Optometrist
  • Sedona, AZ
National Provider Identifier
1255304754
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1467 Issued in AZ
Practice address
100 Verde Valley School Road
Suite 114
Sedona, AZ 86351
Phone
(928) 239-9901
Fax
(928) 239-9902
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1467 AZ Primary

Addresses

Primary practice location

100 Verde Valley School Road
Suite 114
Sedona, AZ 86351

Mailing address

100 Verde Valley School Road
Suite 114
Sedona, AZ 86351
Phone (928) 239-9901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000711 AZ Practitioner - Optometry 8628011400 Reassigns benefits to 1 organization
Practice locations: Sedona, AZ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Verde Valley School Rd
Suite 114
Sedona, AZ 86351-9053

Hospital & facility affiliations

  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score
86.93 of 100Reported as individual
Quality
73.86
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
496NMMDRegistered Dietitian
1467AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Boutique of Sedona, PLLC Optometrist CurrentSince Aug 6, 2013 Accepting new patients

Locations

100 Verde Valley School Rd
Ste 114
Sedona, AZ 86351
Phone (928) 239-9901

100 Verde Valley School Rd
Ste 105
Sedona, AZ 86351
Phone (928) 284-1289

100 Verde Valley School Rd
Sedona, AZ 86351
Phone (928) 239-9901

Interoperability endpoints

  • Direct secure messaging: carolyn.martin@direct.revolutionehr.com

Organizations & group practices 1

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 2

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1255304754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VERDE VALLEY SCHOOL ROAD",
            "address_2": "SUITE 114",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "86351",
            "telephone_number": "928-239-9901",
            "fax_number": "928-239-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VERDE VALLEY SCHOOL ROAD",
            "address_2": "SUITE 114",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "86351",
            "telephone_number": "928-239-9901",
            "fax_number": "928-239-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAROLYN",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedona, AZ

Sources for this page

Verify at the official NPI Registry.