Active NPI
Richard Martines, D.O.
- Dermatology Physician
- Sayre, PA
National Provider Identifier
1700857257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- OS004256L
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | OS004256L | PA | Primary |
| Dermatology Physician | 207N00000X | 166095-1 | NY |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0011266060001 | Medicaid | PA | |
| 110069222 | Other | PA | RR MEDICARE PIN |
| CC8362 | Other | NY | RR MEDICARE GROUP |
| CC9269 | Other | PA | RR MEDICARE GROUP |
| 01088137 | Medicaid | NY | |
| GU039820 | Other | PA | PA MEDICARE GROUP |
| P00196063 | Other | NY | RR MEDICARE PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rmartines8329@direct-guthrie.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166095-1 | NY | MD | Dermatology Physician |
| OS004256L | PA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group, P.C. | Dermatology | Current | Accepting new patients |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Dermatology | Current | Accepting new patients |
| Guthrie Medical Group, P.C. | Past | Accepting new patients |
Locations
130 Center Way
Corning, NY 14830
Phone (607) 936-9971
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Interoperability endpoints
- rmartines8329@direct-guthrie.org
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Athens, PA
- NPI 1962451153
-
- Multi-Specialty Clinic/Center
- Corning, NY
- NPI 1134178635
-
- Dermatology Physician
- Sayre, PA
- NPI 1164474508
-
- Family Medicine Physician
- Troy, PA
- NPI 1376592493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1700857257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINES",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "OS004256L",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "166095-1",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0011266060001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "110069222",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC8362",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC9269",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01088137",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICARE GROUP",
"identifier": "GU039820",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "P00196063",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rmartines8329@direct-guthrie.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1 Guthrie Sq",
"city": "Sayre",
"state": "PA",
"country_code": "US",
"postal_code": "188401625",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sayre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.