Paul L. Martin Jr., PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY3148 Issued in FL

Practice address

2200 N Ponce de Leon Blvd Ste 3
St Augustine, FL 32084-2650

Phone

(904) 829-9859

Fax

(904) 315-7015

NPI assigned

Mar 30, 2007

Last updated

Apr 27, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1548380686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N PONCE DE LEON BLVD STE 3",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842650",
            "fax_number": "904-315-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N PONCE DE LEON BLVD STE 3",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842650",
            "telephone_number": "904-829-9859",
            "fax_number": "904-315-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAUL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY3148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rommel Marson
• Alan J Martin
• Margaret E Martin, ARNP
• Mary Kathleen Martin, CRNA
• Pamela R Martin, D.M.D.
• Tiffany Martin, LM, CPM
• Van Martin III
• Victoria Martin
• Victoria Martin, OTR/L
• Amber Jill Martinez, M.S., CCC-SLP

• Psychologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.