Active NPI
Martin W. Isenman, MD
- Internal Medicine Physician
- Melbourne, FL
National Provider Identifier
1366433021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME26700
- Practice address
- 1223 Gateway Drive
Melbourne, FL 32901-2607 - Phone
- (321) 725-4500
- Fax
- (321) 409-3685
- NPI assigned
- Nov 2, 2005
- Last updated
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME26700 | FL | Primary |
Addresses
Primary practice location
1223 Gateway Drive
Melbourne, FL 32901-2607
Mailing address
1223 Gateway Drive
Melbourne, FL 32901-2607
Phone (321) 725-4500
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 |
|---|---|---|---|
| ME26700 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holmes Regional Medical Center, Inc. | Past | Accepting new patients |
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": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1366433021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1223 GATEWAY DRIVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012607",
"telephone_number": "321-725-4500",
"fax_number": "321-409-3685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1223 GATEWAY DRIVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012607",
"telephone_number": "321-725-4500",
"fax_number": "321-409-3685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISENMAN",
"first_name": "MARTIN",
"middle_name": "W.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME26700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.