Individual provider Active NPI

Max Martin, NP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1538647409
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008311A Issued in IN
Practice address
5853 Sherman Ave
Indianapolis, IN 46220-5421
Phone
(317) 652-4537
NPI assigned
Aug 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71008311A IN Primary

Addresses

Primary practice location

5853 Sherman Ave
Indianapolis, IN 46220-5421

Mailing address

7240 E 82ND St
Indianapolis, IN 46256-1404
Phone (317) 849-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211025000469 IN Practitioner - Nurse Practitioner 4981092962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

9660 E Washington St
Suite 300
Indianapolis, IN 46229-3032
Phone (317) 860-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
71008311AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cleanslate Medical Group of Indiana LLC CurrentSince Jul 1, 2022 Accepting new patients
Major Hospital Past Accepting new patients

Locations

101 N Harrison St
Alexandria, IN 46001
Phone (765) 233-0903

4925 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 442-0402

4925 S Scatterfield Rd
#G
Anderson, IN 46013
Phone (765) 442-0402

203 W 1st St
Bloomington, IN 47403
Phone (812) 339-1675

1004 Parkway Ave
Ste E
Elkhart, IN 46516
Phone (574) 218-7131

4411 Washington Ave
Ste 105
Evansville, IN 47714
Phone (812) 213-0304

3005 E State Blvd
Fort Wayne, IN 46805
Phone (260) 267-9498

833 Indianapolis Rd
Ste E
Greencastle, IN 46135
Phone (765) 301-3680

65 Airport Pkwy
Ste 114
Greenwood, IN 46143
Phone (317) 807-0268

1725 N Meridian St
Indianapolis, IN 46202
Phone (317) 396-1676

9660 E Washington St
#300
Indianapolis, IN 46229
Phone (317) 860-5600

3728 S Reed Rd
Kokomo, IN 46902
Phone (765) 626-7110

30 Professional Ct
Ste 2
Lafayette, IN 47905
Phone (765) 838-1218

8601 Connecticut St
Merrillville, IN 46410
Phone (219) 525-3495

124 E Main St
Muncie, IN 47305
Phone (765) 587-7311

18051 River Rd
Ste 101
Noblesville, IN 46062
Phone (317) 674-0062

2455 E Main St
#194
Plainfield, IN 46168
Phone (317) 268-7198

2302 Chester Blvd
Ste A
Richmond, IN 47374
Phone (765) 488-0345

2936 Frontage Rd
Warsaw, IN 46580
Phone (574) 306-2145

Organizations & group practices 2

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1538647409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 E 82ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561404",
            "telephone_number": "317-849-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5853 SHERMAN AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462205421",
            "telephone_number": "317-652-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MAX",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008311A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.