Individual provider Active NPI

Alan John Martin, MD

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1396728457
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2004016559 Issued in MO
Practice address
12634 Olive Blvd
Dept Emergency Med
Saint Louis, MO 63141-6337
Phone
(314) 996-8470
Fax
(314) 747-3338
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2004016559 MO Primary

Addresses

Primary practice location

12634 Olive Blvd
Dept Emergency Med
Saint Louis, MO 63141-6337

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 996-8470

Other identifiers 1

IdentifierTypeStateIssuer
209055706MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050127000688 MO Practitioner - Emergency Medicine 9739139767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

400 S Kingshighway Blvd
Saint Louis, MO 63110-1014
Phone (314) 454-7900

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004016559MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Dec 1, 2023 Accepting new patients
Emergency Physicians of St. Luke'S, LLC Emergency Medicine CurrentSince Mar 1, 2014 Accepting new patients
Washington University CurrentSince Dec 1, 2023 Accepting new patients
Physician Specialists of St Lukes LLC Emergency Medicine CurrentSince May 1, 2019 Accepting new patients

Locations

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

400 S Kingshighway Blvd
#F
Saint Louis, MO 63110
Phone (314) 454-7900

660 S Euclid Ave
#8072
Saint Louis, MO 63110
Phone (314) 362-9177

12634 Olive Blvd
Saint Louis, MO 63141
Phone (314) 434-0600

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

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.

Hospital & facility affiliations 2

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1396728457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-996-8470",
            "fax_number": "314-747-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12634 OLIVE BLVD",
            "address_2": "DEPT EMERGENCY MED",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416337",
            "telephone_number": "314-996-8470",
            "fax_number": "314-747-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2004016559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209055706",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "12634 Olive Blvd",
            "address_2": "Dept Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.