Individual provider Active NPI

Heather A Marten, MD

  • Pediatrics Physician
  • Stevensville, MI
National Provider Identifier
1285670448
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301087406 Issued in MI
Practice address
5515 Cleveland Ave
Stevensville, MI 49127-9670
Phone
(269) 429-6604
Fax
(269) 429-1715
NPI assigned
Jun 22, 2006
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301087406 MI Primary

Addresses

Primary practice location

5515 Cleveland Ave
Stevensville, MI 49127-9670

Mailing address

5515 Cleveland Ave
Stevensville, MI 49127-9670
Phone (269) 471-1700

Other practice location 1

2002 S 11th St
Niles, MI 49120-4074
Phone (269) 687-0200

Other identifiers 2

IdentifierTypeStateIssuer
3501110942OtherMIBLUE CROSS PIN
4875792MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060823000123 MI Practitioner - Pediatric Medicine 7315940863 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301087406MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet CurrentSince Apr 2, 2025 Accepting new patients
Lakeland Medical Practices CurrentSince Jun 1, 2010 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Apr 2, 2025 Accepting new patients
Lakeland Medical Practices CurrentSince Jun 1, 2010 Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

6416 Deans Hill Rd
Berrien Ctr, MI 49102
Phone (269) 471-7741

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

5515 Cleveland Ave
Stevensville, MI 49127
Phone (269) 429-9644

5515 Cleveland Ave
Ste 1
Stevensville, MI 49127
Phone (269) 429-6604

Interoperability endpoints

  • Direct secure messaging: hmarten260906@epic00.shdirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1285670448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-471-1700",
            "fax_number": "269-471-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-6604",
            "fax_number": "269-429-1715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491204074",
            "country_code": "US",
            "telephone_number": "269-687-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTEN",
        "first_name": "HEATHER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301087406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "3501110942",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4875792",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MI

Sources for this page

Verify at the official NPI Registry.