Individual provider Active NPI

Jose Angel Martin, DO

  • Surgery Physician
  • Tamarac, FL
National Provider Identifier
1609016849
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS 12458 Issued in FL
Practice address
7421 N University Dr Ste 305
Tamarac, FL 33321-6102
Phone
(954) 233-0913
Fax
(954) 391-5011
NPI assigned
Feb 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS 12458 FL Primary

Addresses

Primary practice location

7421 N University Dr Ste 305
Tamarac, FL 33321-6102

Mailing address

7421 N University Dr Ste 305
Tamarac, FL 33321-6102
Phone (954) 233-0913

Other identifiers 1

IdentifierTypeStateIssuer
011955500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102000757 FL Practitioner - General Surgery 6002049012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Surgical Specialists LLCGroup PAC ID 5799881660, 91 clinicians

Practice addresses (Care Compare)

7401 N University Dr
Suite 103
Tamarac, FL 33321-2933
Phone (954) 341-9771

Hospital & facility affiliations

  • University Hospital and Medical Center Hospital, Tamarac, FL, CCN 100224
  • Broward Health Coral Springs Hospital, Coral Springs, FL, CCN 100276
  • HCA Florida University Hospital Hospital, Davie, FL, CCN 100360

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 12458FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Surgical Specialists LLC Surgery CurrentSince Sep 1, 2020 Accepting new patients
MG Medical LLC PastSince Mar 29, 2020 Accepting new patients

Locations

1951 SW 172nd Ave
Ste 200
Miramar, FL 33029
Phone (305) 330-6692

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

7421 N University Dr
Ste 305
Tamarac, FL 33321
Phone (954) 233-0913

7401 N University Dr
Ste 103
Tamarac, FL 33321
Phone (954) 233-0913

Interoperability endpoints

  • Direct secure messaging: jose.martin@169198142619652.direct.elationemr.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1609016849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 305",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333216102",
            "telephone_number": "954-233-0913",
            "fax_number": "954-391-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 305",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333216102",
            "telephone_number": "954-233-0913",
            "fax_number": "954-391-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOSE",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-28",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS 12458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011955500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.