Active NPI
Michael Stephen Martin, O.D.
- Optometrist
- Portland, OR
National Provider Identifier
1316059512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001048TX
- Practice address
- 3600 N Interstate Ave
Portland, OR 97227-1106 - Phone
- (503) 285-9321
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00001048TX | WA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 1240ATI | OR |
Addresses
Primary practice location
3600 N Interstate Ave
Portland, OR 97227-1106
Mailing address
PO Box 19029
Portland, OR 97280-0029
Phone (503) 246-7408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD00001048TX | WA | MD | Optometrist |
| 1240ATI | OR | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1316059512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19029",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972800029",
"telephone_number": "503-246-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 N INTERSTATE AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271106",
"telephone_number": "503-285-9321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MICHAEL",
"middle_name": "STEPHEN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001048TX",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "OR",
"license": "1240ATI",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.