Individual provider Active NPI

David J Martini, MD

  • Surgery Physician
  • Danvers, MA
National Provider Identifier
1417946799
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39883 Issued in MA
Practice address
104 Endicott St
Suite 200
Danvers, MA 01923-3623
Phone
(978) 882-6899
Fax
(978) 882-6890
NPI assigned
Oct 19, 2005
Last updated
Aug 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39883 MA Primary

Addresses

Primary practice location

104 Endicott St
Suite 200
Danvers, MA 01923-3623

Mailing address

55 Fruit St
Yawkey Building, 7TH Floor
Boston, MA 02114-2621
Phone (617) 726-8290

Other identifiers 4

IdentifierTypeStateIssuer
705904OtherMATUFTS
M09597OtherMABCBS
2058162MedicaidMA
8913OtherMAHPHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39883MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Eye Group, P.C. Past Accepting new patients
David J Martini MD Surgery Past Accepting new patients
Dr. John G. Hernandez & Assoc. Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1417946799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY BUILDING, 7TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8290",
            "fax_number": "617-724-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 200",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-882-6899",
            "fax_number": "978-882-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "39883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "705904",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M09597",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2058162",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "8913",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.