Individual provider Active NPI

Samantha Doris Martin

  • Pediatric Hematology & Oncology Physician
  • Boston, MA
National Provider Identifier
1336777309
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
W4894 Issued in TX
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-2000
NPI assigned
Mar 27, 2020
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X W4894 TX
Pediatric Hematology & Oncology Physician 2080P0207X W4894 TX Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

175 Cambridge St
Boston, MA 02114-2743

Other practice location 1

6701 Fannin St Ste 1400
Houston, TX 77030-2613
Phone (832) 824-1000 ext. 62379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260406003723 TX Practitioner - Pediatric Medicine 4082189154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Massachusetts Medical School, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1102 Bates Ave
Houston, TX 77030-2698

PO Box
Dallas, TX 75284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
W4894TXMDPediatrics Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1336777309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6701 Fannin St Ste 1400",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302613",
            "country_code": "US",
            "telephone_number": "832-824-1000 x62379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SAMANTHA",
        "middle_name": "DORIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "W4894",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "W4894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.