Active NPI
Carla M. Martin, MD
- Internal Medicine Physician
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD10551
- Practice address
- 355 Prairie Ave
Providence, RI 02905-1928 - Phone
- (401) 444-0570
- Fax
- (401) 444-0427
- NPI assigned
- Dec 8, 2005
- Last updated
- Apr 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD10551 | RI | Primary |
| Pediatrics Physician | 208000000X | MD10551 | RI |
Addresses
Primary practice location
355 Prairie Ave
Providence, RI 02905-1928
Mailing address
375 Allens Ave
Providence, RI 02905-5010
Phone (401) 780-2511
Other practice location 1
407 East Ave
Suite 150
Pawtucket, RI 02860-5299
Phone (401) 616-1642
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CM36051 | Medicaid | RI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | carla.martin@providencechc.directbygreenway.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Rutgers New Jersey Medical School, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
355 Prairie Ave
Providence, RI 02905-1928
Phone (401) 444-0570
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD10551 | RI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Community Health Centers, Inc | Current | Accepting new patients | |
| Blackstone Valley Community Health Care, Inc. | Current | Accepting new patients | |
| Blackstone Valley Community Health Care, Inc. | Current | Accepting new patients | |
| The Providence Center Inc | Past | Accepting new patients | |
| Memorial Hospital | Internal Medicine | Past | Accepting new patients |
Locations
1000 Broad St
Central Falls, RI 02863
Phone (401) 722-0081
9 Chestnut St
Central Falls, RI 02863
Phone (401) 722-0081
39 East Ave
Pawtucket, RI 02860
Phone (401) 722-0081
1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500
1 Warren Way
Providence, RI 02905
Phone (401) 444-0400
239 Cranston St
Providence, RI 02907
Phone (401) 444-0580
31 Atwood St
Providence, RI 02909
Phone (401) 415-9000
375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400
40 Candace St
Providence, RI 02908
Phone (401) 444-0550
530 N Main St
Providence, RI 02904
Phone (401) 274-2500
Interoperability endpoints
- carla.martin.p1@direct.bvchc.nextgenshare.com
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- Providence, RI
- NPI 1053313593
-
- Federally Qualified Health Center (FQHC)
- Pawtucket, RI
- NPI 1063574135
-
- Federally Qualified Health Center (FQHC)
- Central Falls, RI
- NPI 1275847766
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Providence, RI
- NPI 1104847946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619568000000",
"number": "1376528794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 ALLENS AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029055010",
"telephone_number": "401-780-2511",
"fax_number": "401-780-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 PRAIRIE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029051928",
"telephone_number": "401-444-0570",
"fax_number": "401-444-0427"
}
],
"practiceLocations": [
{
"address_1": "407 East Ave",
"address_2": "Suite 150",
"address_purpose": "LOCATION",
"city": "Pawtucket",
"state": "RI",
"postal_code": "028605299",
"country_code": "US",
"telephone_number": "401-616-1642",
"fax_number": "401-728-4437",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "CARLA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-08",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD10551",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "MD10551",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CM36051",
"state": "RI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "carla.martin@providencechc.directbygreenway.com",
"affiliation": "N",
"address_1": "355 Prairie Ave",
"city": "Providence",
"state": "RI",
"country_code": "US",
"postal_code": "029051928",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
- 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.