Individual provider Active NPI

David C Martin, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1689765455
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14327 Issued in OK
Practice address
1725 E 19TH St
Ste 602
Tulsa, OK 74104-5437
Phone
(918) 748-7677
Fax
(918) 748-7606
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14327 OK Primary

Addresses

Primary practice location

1725 E 19TH St
Ste 602
Tulsa, OK 74104-5437

Mailing address

1725 E 19TH St
Ste 602
Tulsa, OK 74104-5437
Phone (918) 748-7677

Other identifiers 2

IdentifierTypeStateIssuer
731412934OtherOKCOMMERCIAL
730536372059OtherOKBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20171003005249 TX Practitioner - Internal Medicine 8123106747 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Sep 3, 2017 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Sep 3, 2017 Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
#Three
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

471688 Highway 51
Stilwell, OK 74960

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: david.martin@direct.stjohnhealthsystem.com

Organizations & group practices 6

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1689765455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "STE 602",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045437",
            "telephone_number": "918-748-7677",
            "fax_number": "918-748-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "STE 602",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045437",
            "telephone_number": "918-748-7677",
            "fax_number": "918-748-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "14327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "731412934",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "730536372059",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.