Individual provider Active NPI

Brad Allyn Marten, PSY.D.

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1558425397
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1395 Issued in CO
Practice address
19 N Tejon St
Suite 303G
Colorado Springs, CO 80903-1534
Phone
(719) 471-3125
Fax
(719) 488-1733
NPI assigned
Dec 19, 2006
Sex
Male
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
Clinical Psychologist 103TC0700X 1395 CO Primary

Addresses

Primary practice location

19 N Tejon St
Suite 303G
Colorado Springs, CO 80903-1534

Mailing address

19 N Tejon St
Suite 303G
Colorado Springs, CO 80903-1534
Phone (719) 471-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20050901000677 CO Practitioner - Clinical Psychologist 4981636669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4465 Northpark Dr
Suite 300
Colorado Springs, CO 80907-4238
Phone (719) 471-3125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1395COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Marten Psychotherapy Associates, P.C. Clinical CurrentSince Sep 1, 2008 Accepting new patients
Phonda Hackett, PSYD Clinical Past Accepting new patients
Gary W. Lee Past Accepting new patients

Locations

4465 Northpark Dr
Ste 300
Colorado Springs, CO 80907
Phone (719) 471-3125

Organizations & group practices 3

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558425397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N TEJON ST",
            "address_2": "SUITE 303G",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031534",
            "telephone_number": "719-471-3125",
            "fax_number": "719-488-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N TEJON ST",
            "address_2": "SUITE 303G",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031534",
            "telephone_number": "719-471-3125",
            "fax_number": "719-488-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTEN",
        "first_name": "BRAD",
        "middle_name": "ALLYN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.