Reginald Willis Martin, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MS 13610 Issued in MS

Practice address

971 Lakeland Dr Ste 211
Jackson, MS 39216-4607

Phone

(601) 200-4350

Fax

(601) 200-4356

NPI assigned

Mar 28, 2007

Last updated

Mar 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

General Surgery

Education

Morehouse School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Dominic Medical Associates LLCGroup PAC ID 0446303168, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Merit-based Incentive Payment System (MIPS)

Final score

89.09 of 100Reported as apm

Quality

73.43

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmartin2270491@direct.casso.us.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Dominic Medical Associates LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1407920549
  Medicare reassignment Care Compare group NPD
• St Dominic Medical Associates LLC

  dba St Dominic Pallative Care

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1285987578
  NPD
• St Dominic Medical Associates

  dba Martin Surgical Associates

  • Surgery Physician
  • Jackson, MS
  • NPI 1669742417
  NPD (past)
• St Dominic Medical Associates LLC

  dba St. Dominic Family Practice Associates-Jackson

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1508263179
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mississippi Homecare of Jackson II, LLC

  dba Mississippi HomeCare / Jackson

  • Home Health Agency
  • Jackson, MS
  • NPI 1730373275
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1679692396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 211",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164607",
            "telephone_number": "601-200-4350",
            "fax_number": "601-200-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "REGINALD",
        "middle_name": "WILLIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "MS 13610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112817",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01151405",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lora Michelle Martin, FNP-C
• Lorraine Martin, NP
• Murphy S Martin, MD
• Pamela Deloach Martin, LPC
• Peter Carlos Martin, MD
• Rick Martin, M.D.
• Timothy Glynn Martin
• Tina Martin, N.P.
• Jeff Martinez, MAT, ATC
• Jessica G Martinez

• Surgery Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.