Active NPI
Douglas Flynn Martin, MD
- Neurological Surgery Physician
- Boca Raton, FL
National Provider Identifier
1609977339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 0034683
- Practice address
- 875 Meadows Rd
Suite 311
Boca Raton, FL 33486-2349 - Phone
- (561) 368-5488
- Fax
- (561) 367-0145
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 0034683 | FL | Primary |
Addresses
Primary practice location
875 Meadows Rd
Suite 311
Boca Raton, FL 33486-2349
Mailing address
875 Meadows Rd
Suite 311
Boca Raton, FL 33486-2349
Phone (561) 368-5488
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090430000129 | FL | Practitioner - Neurosurgery | 1456409507 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0034683 | FL | MD | Neurological Surgery Physician |
| 34683 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1609977339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 MEADOWS RD",
"address_2": "SUITE 311",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334862349",
"telephone_number": "561-368-5488",
"fax_number": "561-367-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 MEADOWS RD",
"address_2": "SUITE 311",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334862349",
"telephone_number": "561-368-5488",
"fax_number": "561-367-0145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "DOUGLAS",
"middle_name": "FLYNN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "FL",
"license": "0034683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.