Individual provider Active NPI

Martyn Knowles, MD

  • Surgery Physician
  • Raleigh, NC
National Provider Identifier
1265632731
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2015-00304 Issued in NC
Practice address
4414 Lake Boone TRL
Suite 108
Raleigh, NC 27607-7513
Phone
(919) 397-9772
NPI assigned
Jul 23, 2007
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2015-00304 NC Primary
Vascular Surgery Physician 2086S0129X 2015-00304 NC

Addresses

Primary practice location

4414 Lake Boone TRL
Suite 108
Raleigh, NC 27607-7513

Mailing address

4414 Lake Boone TRL
Suite 108
Raleigh, NC 27607-7513

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mknowles118453@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150709001538 NC Practitioner - Vascular SurgeryPractitioner - General Surgery 8527285428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Carolina Nephrology PAGroup PAC ID 0244511483, 58 clinicians
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

3031 New Bern Ave
Suite 200
Raleigh, NC 27610-2989
Phone (919) 747-7820

4414 Lake Boone TRL
Suite 505
Raleigh, NC 27607-7521
Phone (919) 784-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion19
Varicose vein removal33
Leg revascularization (restoring blood flow)16
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Surgery CurrentSince Jun 1, 2025 Accepting new patients
North Carolina Nephrology PA CurrentSince Sep 1, 2024 Accepting new patients
North Carolina Nephrology PA CurrentSince Sep 1, 2024 Accepting new patients
Rex Hospital Inc Surgery PastSince May 1, 2015 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

781 Avent Ferry Rd
Ste 212
Holly Springs, NC 27540
Phone (984) 974-4010

3031 New Bern Ave
Ste 200
Raleigh, NC 27610
Phone (919) 747-7820

4414 Lake Boone Trl
Ste 505
Raleigh, NC 27607
Phone (984) 974-0500

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2824 Rogers Rd
Ste 104
Wake Forest, NC 27587

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1265632731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL",
            "address_2": "SUITE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL",
            "address_2": "SUITE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077513",
            "telephone_number": "919-397-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "MARTYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2015-00304",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2015-00304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mknowles118453@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4414 Lake Boone Trl",
            "address_2": "Suite 108",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.