Michael Glen Martin, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

020848 Issued in NY

Practice address

222 E Middle Country Rd Ste 226
Smithtown, NY 11787-2873

Phone

(631) 724-5788

Fax

(631) 724-5177

NPI assigned

Jul 11, 2006

Last updated

Mar 5, 2021By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Montefiore Medical Center

  • Physical Therapist
  • Pomona, NY
  • NPI 1942012851
  NPD (past)
• Progressive Physical Medicine and Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Mineola, NY
  • NPI 1740216126
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1316971559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E MIDDLE COUNTRY RD STE 226",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872873",
            "telephone_number": "631-724-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E MIDDLE COUNTRY RD STE 226",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872873",
            "telephone_number": "631-724-5788",
            "fax_number": "631-724-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "middle_name": "GLEN",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11348666",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Ashley Marte
• Emma Louise Martin, LMSW
• Gary Andre Martin, RN
• Jeffrey L Martin, MD
• Leslie Martin, LMT
• Elsy E. Martinez, LMHC
• Kathryn Martino
• Maria C Martino, MHC-LP
• Noelle Marvelli
• Mascaro Health, Inc. (Mascaro Mental Health Group)

• Physical Therapist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.