Individual provider Active NPI

Michael J Martin, OD

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1598840217
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
817 Issued in AZ
Practice address
4800 N 22ND St
Phoenix, AZ 85016-4701
Phone
(602) 508-4943
Fax
(602) 508-4830
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 817 AZ Primary

Addresses

Primary practice location

4800 N 22ND St
Phoenix, AZ 85016-4701

Mailing address

4800 N 22ND St
Phoenix, AZ 85016-4701
Phone (602) 508-4943

Other identifiers 1

IdentifierTypeStateIssuer
773938MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000791 AZ Practitioner - Optometry 9739203530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4800 N 22ND St
Suite 120
Phoenix, AZ 85016-4962
Phone (602) 955-1000

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
64.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
817AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Eye Center, LTD Optometrist CurrentSince Jan 1, 2018 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Current Accepting new patients
Southwestern Eye Center LTD Current Accepting new patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Dec 1, 2016 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Dec 1, 2016 Accepting new patients
Southwestern Eye Center, LTD Optometrist CurrentSince Jan 1, 2018 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Past Accepting new patients

Locations

41810 N Venture Dr
Ste E152
Anthem, AZ 85086
Phone (623) 584-9295

3003 Highway 95
Ste 63
Bullhead City, AZ 86442
Phone (928) 763-7555

855 S Dobson Rd
Ste 1
Chandler, AZ 85224

399 W Palomino Rd
Chino Valley, AZ 86323
Phone (928) 636-5504

5285 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 903-0922

1626 N Litchfield Rd
Ste 110
Goodyear, AZ 85395
Phone (817) 995-2500

1151 S La Canada Dr
Ste 200
Green Valley, AZ 85614
Phone (520) 625-8562

5250 E Southern Ave
Mesa, AZ 85206
Phone (480) 420-1005

1055 S Stapley Dr
Mesa, AZ 85204
Phone (480) 833-9100

2610 E University Dr
Mesa, AZ 85213

1815 N Mastick Way
Nogales, AZ 85621
Phone (520) 761-3533

4800 N 22nd St
Ste 210
Phoenix, AZ 85016
Phone (602) 598-7488

4800 N 22nd St
Ste 120
Phoenix, AZ 85016

4800 N 22nd St
Ste 201
Phoenix, AZ 85016

4800 N 22nd St
Phoenix, AZ 85016
Phone (602) 508-4843

13215 N 7th St
Phoenix, AZ 85022

3192 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-1234

3223 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 772-1510

14820 N Del Webb Blvd
Sun City, AZ 85351

13624 W Camino del Sol
Ste 200
Sun City West, AZ 85375
Phone (623) 546-6599

14239 W Bell Rd
Ste 216
Surprise, AZ 85374

5632 E 5th St
Tucson, AZ 85711
Phone (520) 584-8888

698 E Wetmore Rd
Ste 120
Tucson, AZ 85705
Phone (520) 955-1000

10195 N Oracle Rd
Ste 125
Tucson, AZ 85704
Phone (520) 955-1000

698 E Wetmore Rd
Ste 100
Tucson, AZ 85705
Phone (520) 690-5707

Interoperability endpoints

  • Direct secure messaging: michael.martin@direct.avp.nextgenshare.com

Organizations & group practices 7

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1598840217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164701",
            "telephone_number": "602-508-4943",
            "fax_number": "602-508-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164701",
            "telephone_number": "602-508-4943",
            "fax_number": "602-508-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "773938",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.