Individual provider Active NPI

Martin L. Supowitz, D.M.D.

  • Prosthodontics
  • Pittsburgh, PA
National Provider Identifier
1689710287
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DS-022556-L Issued in PA
Practice address
5433 Walnut St
Suite 200
Pittsburgh, PA 15232-3214
Phone
(412) 687-3232
Fax
(412) 535-0303
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DS-022556-L PA Primary

Addresses

Primary practice location

5433 Walnut St
Suite 200
Pittsburgh, PA 15232-3214

Mailing address

5433 Walnut St
Suite 200
Pittsburgh, PA 15232-3214
Phone (412) 687-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629000029 PA Order and Referring Only - DentistPractitioner - Dentist 5991096521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS-022556-LPAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin L. Supowitz, DMD, MSD, LLC Prosthodontics CurrentSince Sep 13, 2020 Accepting new patients

Locations

5433 Walnut St
Ste 200
Pittsburgh, PA 15232
Phone (412) 687-3232

Organizations & group practices 1

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1689710287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 WALNUT ST",
            "address_2": "SUITE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152323214",
            "telephone_number": "412-687-3232",
            "fax_number": "412-535-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 WALNUT ST",
            "address_2": "SUITE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152323214",
            "telephone_number": "412-687-3232",
            "fax_number": "412-535-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPOWITZ",
        "first_name": "MARTIN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS-022556-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.