Individual provider Active NPI

Michael Charles Martin, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1629088026
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A82624 Issued in CA
Practice address
12710 Carmel Country Rd
San Diego, CA 92130-2153
Phone
(858) 499-2600
Fax
(858) 481-9755
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A82624 CA Primary

Addresses

Primary practice location

12710 Carmel Country Rd
San Diego, CA 92130-2153

Mailing address

12710 Carmel Country Rd
San Diego, CA 92130-2153
Phone (858) 499-2600

Other identifiers 1

IdentifierTypeStateIssuer
00A826240MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050923000465 CA Practitioner - Internal Medicine 3375577851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

12710 Carmel Country Rd
San Diego, CA 92130-2153
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Internal Medicine CurrentSince Aug 1, 2005 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 1, 2005 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

2600 Via de la Valle
Ste 200
Del Mar, CA 92014
Phone (858) 309-3160

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

12710 Carmel Country Rd
San Diego, CA 92130
Phone (858) 499-2708

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

Interoperability endpoints

  • Direct secure messaging: mmartin33305@sharphealthcare.direct-ci.com

Organizations & group practices 5

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1629088026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12710 CARMEL COUNTRY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302153",
            "telephone_number": "858-499-2600",
            "fax_number": "858-481-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 CARMEL COUNTRY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302153",
            "telephone_number": "858-499-2600",
            "fax_number": "858-481-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A82624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A826240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.