Martin Blackwell, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

25MB05321100 Issued in NJ

Practice address

109 Maxim Dr
Hopatcong, NJ 07843-1900

Phone

(973) 222-2719

NPI assigned

Oct 19, 2005

Last updated

May 9, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Dermatology

Education

Rowan University School of Osteopathic Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Blackwell Derm

  • Dermatology Physician
  • Newton, NJ
  • NPI 1447016555
  Medicare reassignment NPD Authorized official
• Associated Dermatology

  • Dermatology Physician
  • Newton, NJ
  • NPI 1376721373
  NPD (past) Authorized official
• Martin Blackwell DO LLC

  • Dermatology Physician
  • Newton, NJ
  • NPI 1770856718
  Authorized official Same address or phone
• Clark Dermatology, LLC

  dba Metropolitan Dermatology

  • Dermatology Physician
  • Staten Island, NY
  • NPI 1417316274
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1356330534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 WOODSIDE AVE",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602313",
            "telephone_number": "973-300-0555",
            "fax_number": "973-300-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MAXIM DR",
            "city": "HOPATCONG",
            "state": "NJ",
            "postal_code": "078431900",
            "telephone_number": "973-222-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MB05321100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suat Akgun, MD
• Allied Surgical Assisting
• Allies, Inc.
• Megan Taylor Anderson, CCC-SLP
• Alyssa Bartolotta
• Borough of Hopatcong
• Broadstep Academy-New Jersey, Inc.
• Jessie Grace Marie Brown
• Judith Miriam Burger, LCSW, PSYD
• Buy a Ride Taxi

• Dermatology Physician in Hopatcong, NJ
• Providers in Hopatcong, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.