Individual provider Active NPI

Douglas Flynn Martin, MD

  • Neurological Surgery Physician
  • Boca Raton, FL
National Provider Identifier
1609977339
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
0034683 Issued in FL
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

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090430000129 FL Practitioner - Neurosurgery 1456409507

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0034683FLMDNeurological Surgery Physician
34683FLMDPhysical 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

Verify at the official NPI Registry.