Individual provider Active NPI

Martha M. Munden, M.D.

  • Pediatric Radiology Physician
  • Houston, TX
National Provider Identifier
1356331607
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
J9229 Issued in TX
Practice address
6621 Main St.
Houston, TX 77030
Phone
(328) 824-7237
Fax
(832) 825-0160
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2016-02523 NC
Diagnostic Radiology Physician 2085R0202X J9229 TX
Diagnostic Radiology Physician 2085R0202X 14458 SC
Pediatric Radiology Physician 2085P0229X J9229 TX Primary
Pediatric Radiology Physician 2085P0229X 47682 TX

Addresses

Primary practice location

6621 Main St.
Houston, TX 77030

Mailing address

6621 Main St.
Houston, TX 77030-1461
Phone (832) 824-7237

Other identifiers 2

IdentifierTypeStateIssuer
118309705MedicaidTX
118309702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NC, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090820000447 TX Practitioner - Diagnostic Radiology 4981776408 Reassigns benefits to 1 organization
I20170120001123 NC Practitioner - Diagnostic Radiology 4981776408 Reassigns benefits to 1 organization
I20210323000839 SC Practitioner - Diagnostic Radiology 4981776408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6651 Main St
Houston, TX 77030-2351
Phone (832) 826-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-02523NCMDDiagnostic Radiology Physician
J9229TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Jan 19, 2017 Accepting new patients
University Medical Associates of the Medical University of South Carol Diagnostic Radiology CurrentSince Mar 11, 2021 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Jan 19, 2017 Accepting new patients
Pediatric Radiology Associates, PC Pediatric Radiology Past Accepting new patients
Pediatric Radiology Associates PC Pediatric Radiology Past Accepting new patients

Locations

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1356331607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 MAIN ST.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301461",
            "telephone_number": "832-824-7237",
            "fax_number": "832-825-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 MAIN ST.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "328-824-7237",
            "fax_number": "832-825-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDEN",
        "first_name": "MARTHA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2016-02523",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J9229",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "14458",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "J9229",
            "primary": true
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "47682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118309705",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118309702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.