Martin Martinicky

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

432741 Issued in NY

Practice address

61 Jericho Tpke
Jericho, NY 11753-1051

Phone

(516) 544-8899

Fax

(516) 362-3939

NPI assigned

Aug 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Neuro Pain Care, P.C

  • Specialist
  • Fresh Meadows, NY
  • NPI 1629126974
  Medicare reassignment NPD

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1417630302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9972 66TH RD APT 7D",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744443",
            "telephone_number": "516-587-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 JERICHO TPKE",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531051",
            "telephone_number": "516-544-8899",
            "fax_number": "516-362-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINICKY",
        "first_name": "MARTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Marcial
• Amanda Marcus
• Marissa Resnick, Ms, Ed, LLC
• Olivia Marlin
• Marriage and Family Therapy Solutions, P.C.
• Alan A Mazurek, MD
• Caro E McCarthy, M.D.
• Gerarda McDougall, LCSW
• Emily Meehan
• Kimberly Meere, LCSW

• Acute Care Nurse Practitioner in Jericho, NY
• Providers in Jericho, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.