Individual provider Active NPI

Martin Joseph Clements, MD

  • Obstetrics & Gynecology Physician
  • Edgewood, KY
National Provider Identifier
1306048384
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
40868 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017
Phone
(859) 301-2440
Fax
(859) 301-2493
NPI assigned
Jun 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40868 KY
Family Medicine Physician 207Q00000X MD00049231 WA
Obstetrics & Gynecology Physician 207V00000X 40868 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-2440

Other identifiers 4

IdentifierTypeStateIssuer
0083643MedicaidOH
8511248MedicaidWA
201178670MedicaidIN
7100029610MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20070726000658 KY Practitioner - Family Practice 0547361156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40868KYMDFamily Medicine Physician
MD00049231WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Family Medicine CurrentSince Jun 28, 2013 Accepting new patients
Summit Medical Group, Inc. CurrentSince Jun 28, 2013 Accepting new patients
Lake Chelan Clinic, P.C. Past Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients

Locations

6105 1st Financial Dr
Burlington, KY 41005
Phone (859) 525-1846

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

2300 Chamber Center Dr
Ste 300
Lakeside Park, KY 41017

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: mclements152049@direct-prd.stelizabeth.com

Organizations & group practices 4

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": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1306048384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-2440",
            "fax_number": "859-301-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-2440",
            "fax_number": "859-301-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "MARTIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-03",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "40868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00049231",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "40868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083643",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8511248",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201178670",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100029610",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.