Individual provider Active NPI

Scott Matthew Martin, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Henderson, NV
National Provider Identifier
1386622462
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
15671 Issued in NV
Practice address
2705 W Horizon Ridge Pkwy
Henderson, NV 89052-4434
Phone
(702) 880-4193
Fax
(702) 492-4719
NPI assigned
Jan 9, 2006
Last updated
Jul 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 15671 NV Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A94122 CA

Addresses

Primary practice location

2705 W Horizon Ridge Pkwy
Henderson, NV 89052-4434

Mailing address

2705 W Horizon Ridge Pkwy
Henderson, NV 89052-4434
Phone (702) 880-4193

Other practice location 1

9505 Hillwood Dr
Las Vegas, NV 89134-0506
Phone (949) 444-1413

Other identifiers 1

IdentifierTypeStateIssuer
A94122OtherCACA LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20150507000645 NV Practitioner - Physical Medicine and Rehabilitation 0749211969 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15671NVMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants-Beckett-PLLC CurrentSince Feb 1, 2018 Accepting new patients
Spring Valley Surgery Center, LLC Past Accepting new patients
Mission Hills Surgicenter, LLC Past Accepting new patients
Comprehensive Urgent Care Past Accepting new patients

Locations

10120 S Eastern Ave
Ste 230
Henderson, NV 89052
Phone (702) 487-6880

2565 E Flamingo Rd
Las Vegas, NV 89121
Phone (702) 697-7900

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, 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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1386622462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524434",
            "telephone_number": "702-880-4193",
            "fax_number": "702-492-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524434",
            "telephone_number": "702-880-4193",
            "fax_number": "702-492-4719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9505 Hillwood Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891340506",
            "country_code": "US",
            "telephone_number": "949-444-1413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SCOTT",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NV",
            "license": "15671",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A94122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENCE",
            "identifier": "A94122",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.