Individual provider Active NPI

Peter D Martelly, MD

  • Obstetrics & Gynecology Physician
  • Fall River, MA
National Provider Identifier
1558341511
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
53228 Issued in MA
Practice address
400 Stanley St
Fall River, MA 02720-6009
Phone
(508) 675-1054
Fax
(508) 324-7777
NPI assigned
Jan 18, 2006
Last updated
Jun 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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 53228 MA Primary

Addresses

Primary practice location

400 Stanley St
Fall River, MA 02720-6009

Mailing address

386 Stanley St
Fall River, MA 02720-6009
Phone (508) 675-1054

Other identifiers 1

IdentifierTypeStateIssuer
0170160MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1558341511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 STANLEY ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027206009",
            "telephone_number": "508-675-1054",
            "fax_number": "508-324-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 STANLEY ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027206009",
            "telephone_number": "508-675-1054",
            "fax_number": "508-324-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELLY",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "53228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170160",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.