Individual provider Active NPI

Edward J Martin III, M.D.

  • Anatomic Pathology Physician
  • Gretna, LA
National Provider Identifier
1255367132
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
018796 Issued in LA
Practice address
1141 Whitney Ave
Gretna, LA 70056-5011
Phone
(504) 361-3757
Fax
(504) 361-3132
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 018796 LA Primary

Addresses

Primary practice location

1141 Whitney Ave
Gretna, LA 70056-5011

Mailing address

PO Box 731280
Dallas, TX 75373-1280
Phone (318) 841-9526

Other identifiers 1

IdentifierTypeStateIssuer
1922099MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051214000364 LA Practitioner - Pathology 9032130380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Tulane University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Administrators of the Tulane Educational FundGroup PAC ID 0446163760, 388 clinicians

Practice addresses (Care Compare)

1415 Tulane Ave
New Orleans, LA 70112-2600
Phone (504) 988-5800

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • University Medical Center New Orleans Hospital, New Orleans, LA, CCN 190005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018796LAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Oct 5, 2022 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Oct 5, 2022 Accepting new patients
Southern Pathology, a Professional Medical Corporation Past Accepting new patients
Prytania Pathology Associates LLC Past Accepting new patients
Southern Pathology a Professional Medical Corporation Past Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

2021 Perdido St
New Orleans, LA 70112
Phone (504) 412-1800

Organizations & group practices 6

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 5

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1255367132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731280",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731280",
            "telephone_number": "318-841-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 WHITNEY AVE",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565011",
            "telephone_number": "504-361-3757",
            "fax_number": "504-361-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "LA",
            "license": "018796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922099",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.