NPIMap

Individual provider Active NPI

Martin E. Gilliland, M.D.

  • Family Medicine Physician
  • Jasper, TX
National Provider Identifier
1376509190
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J3107 Issued in TX
Practice address
315 W Houston St
Jasper, TX 75951-4013
Phone
(409) 384-3430
Fax
(409) 383-0571
NPI assigned
Apr 21, 2006
Last updated
Feb 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J3107 TX Primary

Addresses

Primary practice location

315 W Houston St
Jasper, TX 75951-4013

Mailing address

315 W Houston St
Jasper, TX 75951-4013
Phone (409) 384-3430

Other identifiers 1

IdentifierTypeStateIssuer
133051602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000953 TX Practitioner - Family Practice 0648201061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deep East Texas Maternal and Family Health PAGroup PAC ID 7113958539, 5 clinicians

Practice addresses (Care Compare)

315 W Houston St
Jasper, TX 75951-4002
Phone (409) 384-3430

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Deep East Texas Maternal & Family Health PA Family Medicine CurrentSince Oct 27, 1992 Accepting new patients
Clint L Hines Inc Past Accepting new patients
Complete Healthcare Services RHC PLLC Family Medicine PastSince Apr 15, 2008 Accepting new patients
Liberty County Hospital District No 1 Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
Tyler County Hospital District Past Accepting new patients
Woodville II Enterprises, LLC Past Accepting new patients
Sweet Neches Properties, LTD. Past Accepting new patients

Locations

315 W Houston St
Jasper, TX 75951
Phone (409) 384-3430

Organizations & group practices 9

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1376509190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W HOUSTON ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514013",
            "telephone_number": "409-384-3430",
            "fax_number": "409-383-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W HOUSTON ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514013",
            "telephone_number": "409-384-3430",
            "fax_number": "409-383-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "MARTIN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J3107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133051602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

Verify at the official NPI Registry.