Individual provider Active NPI

Heidi M Martin, RN

  • Registered Nurse
  • Westbury, NY
National Provider Identifier
1619363124
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
499912 Issued in NY
Practice address
900 Merchants Concourse
Suite 216
Westbury, NY 11590-5142
Phone
(516) 565-6322
Fax
(516) 565-6325
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 499912 NY Primary

Addresses

Primary practice location

900 Merchants Concourse
Suite 216
Westbury, NY 11590-5142

Mailing address

900 Merchants Concourse
Suite 216
Westbury, NY 11590-5142
Phone (516) 565-6322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
499912NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Maxim of New York, LLC Past Accepting new patients

Organizations & group practices 1

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1619363124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE",
            "address_2": "SUITE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905142",
            "telephone_number": "516-565-6322",
            "fax_number": "516-565-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE",
            "address_2": "SUITE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905142",
            "telephone_number": "516-565-6322",
            "fax_number": "516-565-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "HEIDI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "499912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.