NPIMap

Individual provider Active NPI

Stephen E Martiny, M.D.

  • Family Medicine Physician
  • Cumming, GA
National Provider Identifier
1528212602
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62866 Issued in GA
Practice address
1505 Northside Blvd
Suite 4400
Cumming, GA 30041-7623
Phone
(678) 513-8800
Fax
(678) 513-8500
NPI assigned
Nov 16, 2008
Last updated
Oct 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.092477 OH
Family Medicine Physician 207Q00000X 62866 GA Primary

Addresses

Primary practice location

1505 Northside Blvd
Suite 4400
Cumming, GA 30041-7623

Mailing address

1505 Northside Blvd
Suite 4400
Cumming, GA 30041-7623
Phone (678) 513-8800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephenmartiny@pnfm.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20090818000468 GA Practitioner - Family Practice 8022174291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Perimeter Professional Services, LLCGroup PAC ID 9032337423, 21 clinicians

Practice addresses (Care Compare)

1505 Northside Blvd
Suite 4400
Cumming, GA 30041-8209
Phone (678) 513-8800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62866GAMDFamily Medicine Physician
35.092477OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perimeter Professional Services, LLC Family Medicine CurrentSince Dec 1, 2015 Accepting new patients
Roswell Urgent Care Center LLC Past Accepting new patients
Perimeter North Family Practice LLC Family Medicine PastSince Aug 5, 2012 Accepting new patients
Vine Medical Associates, PC Family Medicine PastSince Jul 14, 2018 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 130
Alpharetta, GA 30005
Phone (770) 664-8898

1505 Northside Blvd
Ste 4400
Cumming, GA 30041
Phone (678) 513-4275

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3612/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stephenmartiny@pnfm.allscriptsdirect.net

Organizations & group practices 4

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": "1226793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1528212602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "SUITE 4400",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "678-513-8800",
            "fax_number": "678-513-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "SUITE 4400",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "678-513-8800",
            "fax_number": "678-513-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINY",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-16",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.092477",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "62866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephenmartiny@pnfm.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1505 Northside Blvd",
            "address_2": "Suite 4400",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300417623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.