Individual provider Active NPI

Martin R. Correa, MD

  • Allergy & Immunology Physician
  • Silver Spring, MD
National Provider Identifier
1255395620
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
D0088565 Issued in MD
Practice address
10301 Georgia Ave Ste 306
Silver Spring, MD 20902-5020
Phone
(013) 681-9670
Fax
(301) 681-6055
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X ME86090 FL
Allergy & Immunology Physician 207K00000X D0088565 MD Primary

Addresses

Primary practice location

10301 Georgia Ave Ste 306
Silver Spring, MD 20902-5020

Mailing address

10301 Georgia Ave Ste 306
Silver Spring, MD 20902-5020
Phone (013) 681-9670

Other identifiers 1

IdentifierTypeStateIssuer
265729500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20200407000344 MD Practitioner - Allergy/Immunology 9638201007
I20200407000429 DC Practitioner - Allergy/Immunology 9638201007 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME86090FLMDAllergy & Immunology Physician
D0088565MDMDAllergy & Immunology Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1255395620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE STE 306",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "013-681-9670",
            "fax_number": "301-681-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE STE 306",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "013-681-9670",
            "fax_number": "301-681-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "MARTIN",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME86090",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MD",
            "license": "D0088565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265729500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.