Individual provider Active NPI

Masen Martin, NP

  • Acute Care Nurse Practitioner
  • Salem, OR
National Provider Identifier
1376920439
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP138447 Issued in TX
Practice address
885 Mission St SE
Salem, OR 97302-6222
Phone
(503) 585-5585
Fax
(503) 587-7823
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201502374NP OR
Acute Care Nurse Practitioner 363LA2100X AP138447 TX Primary

Addresses

Primary practice location

885 Mission St SE
Salem, OR 97302-6222

Mailing address

885 Mission St SE
Salem, OR 97302-6222
Phone (503) 485-2338

Other practice location 1

703 S Fleishel Ave Ste 5000
Tyler, TX 75701-2015
Phone (903) 525-2992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201502374NPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Feb 3, 2025 Accepting new patients
MPP Infusion Center of Tyler LLC CurrentSince Nov 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Feb 3, 2025 Accepting new patients
Salem Health PastSince Apr 23, 2015 Accepting new patients

Locations

1726 Cole Blvd
Ste 250
Lakewood, CO 80401
Phone (303) 384-4064

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

703 S Fleishel Ave
Ste 5000
Tyler, TX 75701
Phone (903) 525-2992

6115 New Copeland Rd
Ste 130
Tyler, TX 75703

Interoperability endpoints

  • Direct secure messaging: mwymore@mpptexas.directbygreenway.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1376920439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 MISSION ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026222",
            "telephone_number": "503-485-2338",
            "fax_number": "503-587-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 MISSION ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026222",
            "telephone_number": "503-585-5585",
            "fax_number": "503-587-7823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 S Fleishel Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-525-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MASEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201502374NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP138447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.