NPIMap

Individual provider Active NPI

John Thomas Martin, MD

  • Anesthesiology Physician
  • Boise, ID
National Provider Identifier
1720031479
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M9126 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1352
Phone
(208) 367-6416
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35.132251 OH
Anesthesiology Physician 207L00000X M9126 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1352

Mailing address

PO Box 7411114
Chicago, IL 60674-1114
Phone (208) 367-5170

Other practice location 1

1055 N Curtis Rd
Boise, ID 83706-1352
Phone (208) 367-6416

Other practice location 2

5151 Reed Rd Ste 225C
Columbus, OH 43220-2553
Phone (614) 884-0641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20041206000963 ID Practitioner - Anesthesiology 3870559412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Cincinnati College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9126IDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Anesthesia, PA Anesthesiology CurrentSince May 14, 2018 Accepting new patients
Boise Anesthesia, P a Anesthesiology CurrentSince May 14, 2018 Accepting new patients
St Alphonsus Professional Medical Services LLC Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
Sacsolano Anesthesia Exchange Medical Group, Inc Anesthesiology Past Accepting new patients
Central Anesthesia Service Exchange Medical Group, Inc. Anesthesiology Past Accepting new patients
Deperro Plastic Surgery, LLC Past Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

Interoperability endpoints

  • Direct secure messaging: jmartin1563791@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 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1720031479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7411114",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606741114",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061352",
            "telephone_number": "208-367-6416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061352",
            "country_code": "US",
            "telephone_number": "208-367-6416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5151 Reed Rd Ste 225C",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432202553",
            "country_code": "US",
            "telephone_number": "614-884-0641",
            "fax_number": "614-884-0641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.132251",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ID",
            "license": "M9126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.