Individual provider Active NPI

Carolyn Martin, MD

  • Obstetrics & Gynecology Physician
  • Seattle, WA
National Provider Identifier
1689685406
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD00035088 Issued in WA
Practice address
1101 Madison St Ste 950
Seattle, WA 98104-3592
Phone
(206) 682-5800
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X MD00035088 WA
Obstetrics & Gynecology Physician 207V00000X MD00035088 WA Primary

Addresses

Primary practice location

1101 Madison St Ste 950
Seattle, WA 98104-3592

Mailing address

805 Madison St Ste 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 1

IdentifierTypeStateIssuer
1016379MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040519001607 WA Practitioner - Obstetrics/Gynecology 8325039217 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00035088WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Apr 1, 2017 Accepting new patients
Proliance Surgeons Inc., P.S. CurrentSince Apr 1, 2017 Accepting new patients

Locations

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

1101 Madison St
Ste 950
Seattle, WA 98104
Phone (206) 355-0800

1101 Madison St
Ste 1150
Seattle, WA 98104
Phone (206) 386-3400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1689685406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 950",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043592",
            "telephone_number": "206-682-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WA",
            "license": "MD00035088",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00035088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016379",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.