Active NPI
Richard J Martin, M.D., D.M.D.
- Plastic and Reconstructive Surgery Physician
- Norwich, CT
National Provider Identifier
1336133446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 036472
- Practice address
- 159 Sachem St
Norwich, CT 06360-4144 - Phone
- (860) 885-0444
- NPI assigned
- Sep 2, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 007905 | CT | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 036472 | CT | Primary |
Addresses
Primary practice location
159 Sachem St
Norwich, CT 06360-4144
Mailing address
159 Sachem St
Norwich, CT 06360-4144
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007905 | CT | MD | Clinical Social Worker |
| 036472 | CT | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320105600000",
"number": "1336133446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 SACHEM ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 SACHEM ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604144",
"telephone_number": "860-885-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "RICHARD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D., D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-02",
"last_updated": "2011-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "CT",
"license": "007905",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "CT",
"license": "036472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.