Individual provider Active NPI

John Thomas Martin, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1447577788
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
287674-1 Issued in NY
Practice address
150 55TH St
Station 12
Brooklyn, NY 11232-2508
Phone
(718) 630-7131
Fax
(718) 630-6286
NPI assigned
Apr 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 287674-1 NY Primary

Addresses

Primary practice location

150 55TH St
Station 12
Brooklyn, NY 11232-2508

Mailing address

421 SW Oak St.
Ste.210
Portland, OR 97204
Phone (503) 988-7468

Other identifiers 2

IdentifierTypeStateIssuer
22959MedicaidOR
096511MedicaidOR

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170720001070 NY Practitioner - Internal Medicine 3779738588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

227 Madison St
New York, NY 10002-7537
Phone (212) 238-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287674-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Internal Medicine CurrentSince Jun 19, 2021 Accepting new patients
NYU Langone Hospitals CurrentSince Aug 1, 2017 Accepting new patients
NYU Langone Hospitals Internal Medicine Current Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Current Accepting new patients
NYU Langone Hospitals CurrentSince Aug 1, 2017 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jun 19, 2021 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

150 55th St
#12
Brooklyn, NY 11220
Phone (718) 630-6632

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447577788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST.",
            "address_2": "STE.210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97204",
            "telephone_number": "503-988-7468",
            "fax_number": "503-988-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "STATION 12",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322508",
            "telephone_number": "718-630-7131",
            "fax_number": "718-630-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "287674-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22959",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096511",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.