Emmanuel M Martakis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

238463 Issued in NY

Practice address

140 Hammond Street
Port Jervis, NY 12771-2607

Phone

(845) 858-2854

Fax

(845) 343-5390

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bon Secours Charity Health System Medical Group, P.C.

  • Internal Medicine Physician
  • Warwick, NY
  • NPI 1487694345

  Pediatrics

  NPD (past)
• Tenafly Pediatrics

  • Pediatrics Physician
  • Tenafly, NJ
  • NPI 1750347647
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1609826023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 987",
            "address_2": "21 ORCHARD STREET",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109405004",
            "telephone_number": "845-343-7614",
            "fax_number": "845-343-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HAMMOND STREET",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712607",
            "telephone_number": "845-858-2854",
            "fax_number": "845-343-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTAKIS",
        "first_name": "EMMANUEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "238463",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD429082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018494050004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02719937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marian Susan Sanborn LCSW PLLC
• Zaharoula Maris, D.M.D.
• Kellie A Markle
• Cynthia Marsilio, A.N.P.
• Barbara Marie Marszalek, FPMHNP
• Tonya Martinez
• Ronny Mazza, RN
• Nancy McGeough Smith, REGISTERED NURSE
• Jill Catrin McLaughlin, FNP-C
• Michele M Doyle

• Pediatrics Physician in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.