Individual provider Active NPI

Michael Martin, LMSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1700164696
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083282 Issued in NY
Practice address
260 E 188TH St
5TH Floor
Bronx, NY 10458-5302
Phone
(718) 960-3382
Fax
(718) 933-2502
NPI assigned
Jul 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 083282 NY Primary

Addresses

Primary practice location

260 E 188TH St
5TH Floor
Bronx, NY 10458-5302

Mailing address

260 E 188TH St
5TH Floor
Bronx, NY 10458-5302
Phone (718) 960-3382

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

State licenses

LicenseStateTypeSpecialty
083282NYMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: sohomd.michaelmartin@157389.advancedmd-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1700164696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E 188TH ST",
            "address_2": "5TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585302",
            "telephone_number": "718-960-3382",
            "fax_number": "718-933-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E 188TH ST",
            "address_2": "5TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585302",
            "telephone_number": "718-960-3382",
            "fax_number": "718-933-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.