NPIMap

Individual provider Active NPI

Martin Aviles, M.D.

  • Obstetrics & Gynecology Physician
  • Natchitoches, LA
National Provider Identifier
1417952102
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
13467R MD Issued in LA
Practice address
627 Bienville Cir
Natchitoches, LA 71457-5744
Phone
(318) 352-9595
Fax
(318) 352-9818
NPI assigned
Jun 17, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13467R LA
Obstetrics & Gynecology Physician 207V00000X 13467R MD LA Primary

Addresses

Primary practice location

627 Bienville Cir
Natchitoches, LA 71457-5744

Mailing address

627 Bienville Cir
Natchitoches, LA 71457-5744
Phone (318) 352-9595

Other identifiers 8

IdentifierTypeStateIssuer
MD.13467ROtherLALA STATE MEDICAL EXAMINERS
1679645071OtherLACORPORATE NPI #
174400000XOtherLAINDIVIDUAL TAXONOMY#
28119OtherCDS#
1428809MedicaidLA
261QM2500XOtherLACORPORATE TAXONOMY CODE
DT5115OtherLAMEDICARE RAILROAD GROUP PTAN#
P01153535OtherLAMEDICARE RAILROAD PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080915000439 LA Practitioner - Obstetrics/Gynecology 2466528559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University Central del Caribe Escuela de Medicina, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NRMC Physician Ipa IncGroup PAC ID 9234400300, 30 clinicians

Practice addresses (Care Compare)

412 Williams Ave
Natchitoches, LA 71457-5155
Phone (318) 527-1147

627 Bienville Cir
Natchitoches, LA 71457-5744
Phone (318) 214-5773

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue160
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13467RLAMDSpecialist
13467R MDLAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NRMC Physician Ipa Inc CurrentSince Mar 1, 2021 Accepting new patients
PDP Health Management, Inc. Current Accepting new patients
PDP Health Management Inc CurrentSince Mar 3, 2017 Accepting new patients
NRMC Physician Ipa Inc CurrentSince Mar 1, 2021 Accepting new patients
Natchitoches Parish Hospital Service District Past Accepting new patients
NRMC Physician Ipa Inc Obstetrics & Gynecology Past Accepting new patients

Locations

501 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200

627 Bienville Cir
Natchitoches, LA 71457
Phone (318) 214-5773

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417952102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BIENVILLE CIR",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575744",
            "telephone_number": "318-352-9595",
            "fax_number": "318-352-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 BIENVILLE CIR",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575744",
            "telephone_number": "318-352-9595",
            "fax_number": "318-352-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "13467R",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "13467R MD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA STATE MEDICAL EXAMINERS",
            "identifier": "MD.13467R",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI #",
            "identifier": "1679645071",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL TAXONOMY#",
            "identifier": "174400000X",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS#",
            "identifier": "28119",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1428809",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE TAXONOMY CODE",
            "identifier": "261QM2500X",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP PTAN#",
            "identifier": "DT5115",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P01153535",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

Verify at the official NPI Registry.