Individual provider Active NPI

Martin C Patrias, M.D.

  • Ophthalmology Physician
  • Jackson, MI
National Provider Identifier
1720078918
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MP404850 Issued in MI
Practice address
1015 Laurence Ave
Jackson, MI 49202
Phone
(517) 787-0364
Fax
(517) 787-2272
NPI assigned
Oct 27, 2005
Last updated
Jul 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MP404850 MI Primary

Addresses

Primary practice location

1015 Laurence Ave
Jackson, MI 49202

Mailing address

1015 Laurence Ave
Jackson, MI 49202-2964
Phone (517) 787-0364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100702000141 MI Practitioner - Ophthalmology 2860425212 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MP404850MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Sight, P.C. Ophthalmology CurrentSince Sep 22, 2000 Accepting new patients
The Center for Sight P.C. PastSince Sep 22, 2000 Accepting new patients

Locations

1015 Laurence Ave
Jackson, MI 49202
Phone (517) 787-0364

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1720078918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022964",
            "telephone_number": "517-787-0364",
            "fax_number": "517-787-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49202",
            "telephone_number": "517-787-0364",
            "fax_number": "517-787-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRIAS",
        "first_name": "MARTIN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "MP404850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.