Kenneth J Martin, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC002881L Issued in PA

Practice address

7331 Brentwood Rd
Philadelphia, PA 19151

Phone

(215) 877-2555

Fax

(215) 877-0240

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in PA

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.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kensington HospitalGroup PAC ID 6305831165, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kensington Hospital- Clinic

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1902955586
  Medicare reassignment Care Compare group NPD
• Kensington Hospital

  • Methadone Clinic
  • Philadelphia, PA
  • NPI 1851745566
  NPD

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1285626804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HELEN CIR",
            "city": "PENN VALLEY",
            "state": "PA",
            "postal_code": "190721222",
            "telephone_number": "215-877-2555",
            "fax_number": "215-877-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7331 BRENTWOOD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19151",
            "telephone_number": "215-877-2555",
            "fax_number": "215-877-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002881L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0060738000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS  PA",
            "identifier": "11940",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLA",
            "identifier": "31875",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE OF PA",
            "identifier": "0104650501",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO ELDERHEALTH",
            "identifier": "1480",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF PA",
            "identifier": "175404",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010465050004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Thelma Martin, M.ED.
• Kathryn Martin
• Kelly Martin, M.D.
• Kellyann Martin, LPC
• Kelsey Martin
• Kenneth Wade Martin, MD
• Kenya N Martin, CRNP
• Keonna Janeen Martin, MS
• Kisha Martin
• Lainie P Martin, M.D.

• Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.