Individual provider Active NPI

Martin W Blain, DPM

  • Podiatrist
  • Woodland Hills, CA
National Provider Identifier
1689645897
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2189 Issued in CA
Practice address
6325 Topanga Canyon Blvd
Ste 103
Woodland Hills, CA 91367-2006
Phone
(818) 346-0041
Fax
(818) 346-5127
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2189 CA Primary

Addresses

Primary practice location

6325 Topanga Canyon Blvd
Ste 103
Woodland Hills, CA 91367-2006

Mailing address

6325 Topanga Canyon Blvd
Ste 103
Woodland Hills, CA 91367-2006
Phone (818) 346-0041

Other identifiers 1

IdentifierTypeStateIssuer
000E21890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
E2189CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1689645897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 TOPANGA CANYON BLVD",
            "address_2": "STE 103",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913672006",
            "telephone_number": "818-346-0041",
            "fax_number": "818-346-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 TOPANGA CANYON BLVD",
            "address_2": "STE 103",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913672006",
            "telephone_number": "818-346-0041",
            "fax_number": "818-346-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIN",
        "first_name": "MARTIN",
        "middle_name": "W",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E21890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.