Individual provider Active NPI

Gary J Martinkus, OD

  • Optometrist
  • Yakima, WA
National Provider Identifier
1699868588
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00000922 Issued in WA
Practice address
3907 Castlevale Rd
Yakima, WA 98902-7802
Phone
(509) 248-5378
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00000922 WA Primary

Addresses

Primary practice location

3907 Castlevale Rd
Yakima, WA 98902-7802

Mailing address

3907 Castlevale Rd
Yakima, WA 98902-7802
Phone (509) 248-5378

Other identifiers 1

IdentifierTypeStateIssuer
2416808MedicaidWA

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
922WAMDChiropractor
OD00000922WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision Care of Yakima PC Optometrist Past Accepting new patients

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1699868588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 CASTLEVALE RD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027802",
            "telephone_number": "509-248-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 CASTLEVALE RD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027802",
            "telephone_number": "509-248-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINKUS",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00000922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2416808",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.