Mimi Pokua Martins, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0088689 Issued in MD

Practice address

3300 Olney Sandy Spring Rd Ste 140
Olney, MD 20832-1494

Phone

(301) 570-6245

Fax

(240) 389-1888

NPI assigned

May 15, 2015

Sex

Female

Sole proprietor

No

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 MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1366820847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "20785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OLNEY SANDY SPRING RD STE 140",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321494",
            "telephone_number": "301-570-6245",
            "fax_number": "240-389-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINS",
        "first_name": "MIMI",
        "middle_name": "POKUA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0088689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Olney, MD
• Providers in Olney, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.