Individual provider Active NPI

John Martin, M.D.

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1396722476
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME77880 Issued in FL
Practice address
7400 Docs Grove Cir
Orlando, FL 32819-8010
Phone
(407) 352-9717
Fax
(407) 354-5425
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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 ME77880 FL Primary

Addresses

Primary practice location

7400 Docs Grove Cir
Orlando, FL 32819-8010

Mailing address

7400 Docs Grove Cir
Orlando, FL 32819-8010
Phone (407) 352-9717

Other identifiers 1

IdentifierTypeStateIssuer
264301400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040421000784 FL Practitioner - Family Practice 3375539851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

239 N Ridgewood Ave
Edgewater, FL 32132-1734
Phone (386) 427-4868

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Oct 8, 2018 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Oct 8, 2018 Accepting new patients
Charles H Moorefield III MD PA Past Accepting new patients

Locations

239 N Ridgewood Ave
Edgewater, FL 32132
Phone (386) 423-4212

1340 Ridgewood Ave
Holly Hill, FL 32117
Phone (386) 676-7100

309 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 445-7073

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

Organizations & group practices 3

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1396722476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 DOCS GROVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198010",
            "telephone_number": "407-352-9717",
            "fax_number": "407-354-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 DOCS GROVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198010",
            "telephone_number": "407-352-9717",
            "fax_number": "407-354-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME77880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264301400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.