Individual provider Active NPI

Martin Martino, M.D.

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1679568547
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16144 Issued in PR
Practice address
Calle Rio Ingenio
Ah-14 Rio Hondo 2
Bayamon, PR 00961-3234
Phone
(787) 923-5403
Fax
(787) 269-5270
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16144 PR Primary

Addresses

Primary practice location

Calle Rio Ingenio
Ah-14 Rio Hondo 2
Bayamon, PR 00961-3234

Mailing address

Calle Rio Ingenio
Ah-14 Rio Hondo 2
Bayamon, PR 00961-3234
Phone (787) 923-5403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20051013000202 PR Practitioner - General Practice 6507881034 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Urb River VW DD4 Calle
25 Ave Comerio
Bayamon, PR 00961-3804
Phone (787) 780-1908

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1679568547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE RIO INGENIO",
            "address_2": "AH-14 RIO HONDO 2",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613234",
            "telephone_number": "787-923-5403",
            "fax_number": "787-269-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE RIO INGENIO",
            "address_2": "AH-14 RIO HONDO 2",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613234",
            "telephone_number": "787-923-5403",
            "fax_number": "787-269-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.