Individual provider Active NPI

Connor Charles Martin, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
National Provider Identifier
1619473055
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
69075 Issued in AZ
Practice address
4582 N 1St Ave Ste 170
Tucson, AZ 85718-8607
Phone
(520) 318-6035
Fax
(520) 795-9953
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 69075 AZ Primary

Addresses

Primary practice location

4582 N 1St Ave Ste 170
Tucson, AZ 85718-8607

Mailing address

4881 E Grant Rd
Tucson, AZ 85712-2704
Phone (520) 829-6776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230620002112 AZ Practitioner - Pain Management 3476936832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Michigan State University College of Human Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4881 E Grant Rd
Tucson, AZ 85712-2704
Phone (520) 829-6776

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
45.68 of 100Reported as group
Quality
40.49
Promoting interoperability
0
Improvement activities
30
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Institute of Southern Arizona Pisa PC Pain Medicine CurrentSince Aug 1, 2023 Accepting new patients
Pain Institute of Southern Arizona Pisa PC Pain Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

4881 E Grant Rd
Tucson, AZ 85712
Phone (520) 829-6776

4582 N 1st Ave
Ste 170
Tucson, AZ 85718
Phone (520) 505-3766

4881 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 829-6776

4582 N 1st Ave
Tucson, AZ 85718

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72783

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 2

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1619473055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122704",
            "telephone_number": "520-829-6776",
            "fax_number": "520-829-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 N 1ST AVE STE 170",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857188607",
            "telephone_number": "520-318-6035",
            "fax_number": "520-795-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CONNOR",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "69075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.