Individual provider Active NPI

Martin David Klinkhammer, M.D.

  • Emergency Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1629135439
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101241199 Issued in VA
Practice address
4092 Foxwood Dr
Ste 101
Virginia Beach, VA 23462-5225
Phone
(757) 686-3508
Fax
(757) 686-0541
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 48157 MN
Emergency Medicine Physician 207P00000X 0101241199 VA Primary

Addresses

Primary practice location

4092 Foxwood Dr
Ste 101
Virginia Beach, VA 23462-5225

Mailing address

PO Box 7549
Portsmouth, VA 23707-0549
Phone (757) 686-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070511000479 VA Practitioner - Emergency Medicine 8527165323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Mayo Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of TidewaterGroup PAC ID 5092618462, 167 clinicians

Practice addresses (Care Compare)

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 686-3508

2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 686-3508

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 686-3508

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

Merit-based Incentive Payment System (MIPS)

Final score
97.87 of 100Reported as group
Quality
95.04
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48157MNMDEmergency Medicine Physician
0101241199VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Tidewater Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients

Locations

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

4092 Foxwood Dr
Ste 101
Virginia Beach, VA 23462
Phone (757) 467-4200

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.

Hospital & facility affiliations 4

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1629135439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7549",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070549",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4092 FOXWOOD DR",
            "address_2": "STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625225",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKHAMMER",
        "first_name": "MARTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "48157",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101241199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.