Individual provider Active NPI

Tasha Martin

  • Surgery Physician
  • Little River, SC
National Provider Identifier
1689060956
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
86651 Issued in SC
Practice address
4000 Highway 9 E Ste 245
Little River, SC 29566-7833
Phone
(843) 366-2940
Fax
(843) 366-2470
NPI assigned
Apr 13, 2015
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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 209897 NC
Surgery Physician 208600000X 86651 SC Primary

Addresses

Primary practice location

4000 Highway 9 E Ste 245
Little River, SC 29566-7833

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 366-2940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20230322001139 LA Practitioner - General Surgery 0749594893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Louisiana State University School of Medicine in New Orleans, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1448 S College Rd
Breast Center at LGMC
Lafayette, LA 70503-2920
Phone (337) 289-8222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy45
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209897NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette General Medical Center Inc. CurrentSince Feb 27, 2023 Accepting new patients
McLeod Physician Associates II Surgery CurrentSince Sep 28, 2021 Accepting new patients
University Hospital & Clinics, Inc. CurrentSince Jun 6, 2023 Accepting new patients
Lafayette General Medical Center Inc. CurrentSince Feb 27, 2023 Accepting new patients
University Hospital & Clinics Inc CurrentSince Jun 6, 2023 Accepting new patients
University Hospital & Clinics, Inc. Past Accepting new patients
Lafayette General Medical Center Inc Past Accepting new patients

Locations

1305 Crowley Rayne Hwy
#200
Crowley, LA 70526
Phone (337) 788-6545

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

1448 S College Rd
Lafayette, LA 70503
Phone (318) 233-5300

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

4000 Highway 9 E
Ste 245
Little River, SC 29566
Phone (843) 366-2940

Interoperability endpoints

  • Direct secure messaging: tmartin1759969@direct.ochsner.org
  • Direct secure messaging: tmartin19717@directmcleodehealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1689060956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-366-2940",
            "fax_number": "843-366-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHWAY 9 E STE 245",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667833",
            "telephone_number": "843-366-2940",
            "fax_number": "843-366-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "209897",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "86651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

Verify at the official NPI Registry.