NPIMap

Individual provider Active NPI

Neil J Martin, MD

  • Anesthesiology Physician
  • Avon, IN
National Provider Identifier
1689749178
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01043286A Issued in IN
Practice address
10706 E US Highway 36
Avon, IN 46123-7982
Phone
(317) 271-3600
Fax
(317) 271-3604
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 01043286A IN
General Practice Physician 208D00000X 01042386A IN
Anesthesiology Physician 207L00000X 01043286A IN Primary

Addresses

Primary practice location

10706 E US Highway 36
Avon, IN 46123-7982

Mailing address

10706 E US Highway 36
Avon, IN 46123-7982
Phone (317) 271-3600

Other identifiers 1

IdentifierTypeStateIssuer
200048850AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101119000005 IN Practitioner - AnesthesiologyPractitioner - General Practice 3274729009 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: General Practice
Education
Indiana University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daviess County HospitalGroup PAC ID 1557271665, 67 clinicians

Practice addresses (Care Compare)

1314 E Walnut St
Washington, IN 47501-2860
Phone 81225486201026

Hospital & facility affiliations

  • Daviess Community Hospital Hospital, Washington, IN, CCN 150061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01043286AINMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daviess County Hospital CurrentSince Sep 1, 2023 Accepting new patients
Daviess County Hospital Current Accepting new patients
Daviess County Hospital CurrentSince Sep 1, 2023 Accepting new patients
Ams Northern Indiana LLC Anesthesiology CurrentSince Feb 1, 2020 Accepting new patients
Great Lakes Anesthesia, P.C. Anesthesiology CurrentSince Sep 1, 2015 Accepting new patients
Deaconess Memorial Medical Center Inc Past Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients

Locations

1004 Parkway Ave
Ste A
Elkhart, IN 46516
Phone (800) 966-7841

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

1402 Grand Ave
Washington, IN 47501
Phone (812) 254-2250

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Interoperability endpoints

  • Direct secure messaging: nmartin1158621@direct.trinity-health.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1689749178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10706 E US HIGHWAY 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237982",
            "telephone_number": "317-271-3600",
            "fax_number": "317-271-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10706 E US HIGHWAY 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237982",
            "telephone_number": "317-271-3600",
            "fax_number": "317-271-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NEIL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01043286A",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01042386A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01043286A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200048850A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.