Individual provider Active NPI

Taliva Donley Martin, M.D.

  • Ophthalmology Physician
  • Fremont, CA
National Provider Identifier
1386822112
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A89123 Issued in CA
Practice address
3200 Kearney St.
Fremont, CA 94538-2299
Phone
(510) 490-1222
Fax
(510) 498-2685
NPI assigned
Feb 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301092053 MI
Ophthalmology Physician 207W00000X A89123 CA Primary

Addresses

Primary practice location

3200 Kearney St.
Fremont, CA 94538-2299

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (510) 498-2857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041227000574 CA Practitioner - OphthalmologyPractitioner - Internal Medicine 7719945500 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, San Francisco School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89123CAMDPharmacist
A89123CAMDOphthalmology Physician
4301092053MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Sutter Bay Hospitals Ophthalmology Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3120 Kearney St
Fremont, CA 94538
Phone (650) 498-3600

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

301 Industrial Rd
#1
San Carlos, CA 94070
Phone (650) 404-8455

2340 Clay St
Ste 100
San Francisco, CA 94115
Phone (415) 202-1500

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: tmartin183744@hisp.ehr.sutterhealth.org

Organizations & group practices 12

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": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1386822112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-498-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 KEARNEY ST.",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382299",
            "telephone_number": "510-490-1222",
            "fax_number": "510-498-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TALIVA",
        "middle_name": "DONLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301092053",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A89123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.