Individual provider Active NPI

Martin Franciszek Porebski

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1295475887
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2025-01541 Issued in NC
Practice address
1021 Morehead Medical Dr
Charlotte, NC 28204-2990
Phone
(980) 442-2000
NPI assigned
Mar 31, 2022
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2025-01541 NC Primary

Addresses

Primary practice location

1021 Morehead Medical Dr
Charlotte, NC 28204-2990

Mailing address

1021 Morehead Medical Dr
Charlotte, NC 28204-2990
Phone (980) 442-2000

Other practice location 1

Ground Floor, Meads Hall, Suite B
Medical Center Boulevard
Winston-Salem, NC 27157
Phone (336) 716-6410

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
I20220624001201 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0648659417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025-01541NCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1295475887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "980-442-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "980-442-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ground Floor, Meads Hall, Suite B",
            "address_2": "Medical Center Boulevard",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "27157",
            "country_code": "US",
            "telephone_number": "336-716-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POREBSKI",
        "first_name": "MARTIN",
        "middle_name": "FRANCISZEK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2025-01541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.