NPIMap

Individual provider Active NPI

Timothy Shane Martin, MD

  • Family Medicine Physician
  • Abilene, TX
National Provider Identifier
1386716686
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K2958 Issued in TX
Practice address
2110 N Willis St
Suite B
Abilene, TX 79603-4359
Phone
(325) 232-8675
Fax
(325) 899-3418
NPI assigned
Nov 14, 2006
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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 K2958 TX Primary

Addresses

Primary practice location

2110 N Willis St
Suite B
Abilene, TX 79603-4359

Mailing address

2110 N Willis St
Suite B
Abilene, TX 79603-4359
Phone (325) 232-8675

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
I20100922000466 TX Practitioner - Family Practice 2860518321 Reassigns benefits to 2 organizations
Practice locations: Abilene, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Tim Martin MD PLLCGroup PAC ID 6002174000, 6 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

2110 N Willis St
Suite B
Abilene, TX 79603-4352
Phone (325) 232-8675

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.17 of 100Reported as individual
Quality
92.83
Promoting interoperability
100
Improvement activities
40
Cost
47.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K2958TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Mansur, FNP Current Accepting new patients
TWMH LLC CurrentSince Oct 1, 2023 Accepting new patients
Dr Tim Martin MD PLLC Family Medicine CurrentSince Jul 25, 2017 Accepting new patients
Abilene Absolute Recovery Solutions CurrentSince May 4, 2021 Accepting new patients
Hendrick Provider Network Family Medicine Past Accepting new patients
Soma Resources, Inc. Past Accepting new patients
Stephens Memorial Hospital District Past Accepting new patients

Locations

1690 N Treadaway Blvd
Abilene, TX 79601
Phone (325) 701-9975

1751 N 15th St
Abilene, TX 79603
Phone (325) 673-3531

2110 N Willis St
Ste B
Abilene, TX 79603
Phone (325) 232-8675

429 N Judge Ely Blvd
Abilene, TX 79601
Phone (325) 400-8586

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15227/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tim.martin.1@15227.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avir at BairdBaird, TX, CCN 675364 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Kinder Hearts HospiceAbilene, TX, CCN 671790 Hospice W-2 Managing Employee Sep 1, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1386716686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 N WILLIS ST",
            "address_2": "SUITE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796034359",
            "telephone_number": "325-232-8675",
            "fax_number": "325-899-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N WILLIS ST",
            "address_2": "SUITE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796034359",
            "telephone_number": "325-232-8675",
            "fax_number": "325-899-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TIMOTHY",
        "middle_name": "SHANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.