Individual provider Active NPI

Susan E Braz-Martin, MD

  • Obstetrics & Gynecology Physician
  • Fall River, MA
National Provider Identifier
1467418251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
213850 Issued in MA
Practice address
1030 President Ave
Fall River, MA 02720-5923
Phone
(508) 676-3411
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 213850 MA Primary

Addresses

Primary practice location

1030 President Ave
Fall River, MA 02720-5923

Mailing address

42 Mikayla Ann Dr
Rehoboth, MA 02769-2549
Phone (508) 252-5338

Other identifiers 1

IdentifierTypeStateIssuer
0182826MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110321000244 MA Practitioner - Obstetrics/Gynecology 3870776420 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Truesdale Obstetrics&Gynecology, PC Obstetrics & Gynecology CurrentSince Aug 6, 2002 Accepting new patients

Locations

1030 President Ave
#2002
Fall River, MA 02720

1030 President Ave
Fall River, MA 02720
Phone (508) 235-6427

Organizations & group practices 1

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467418251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MIKAYLA ANN DR",
            "city": "REHOBOTH",
            "state": "MA",
            "postal_code": "027692549",
            "telephone_number": "508-252-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 PRESIDENT AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205923",
            "telephone_number": "508-676-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZ-MARTIN",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "213850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0182826",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.