Individual provider Active NPI

Joseph Perry Martin, O.D.

  • Optometrist
  • Murray, UT
National Provider Identifier
1730390261
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
111309-9934 Issued in UT
Practice address
166 E 5900 S
Suit B103
Murray, UT 84107-7257
Phone
(801) 268-0408
NPI assigned
May 25, 2007
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 111309-9934 UT Primary

Addresses

Primary practice location

166 E 5900 S
Suit B103
Murray, UT 84107-7257

Mailing address

9862 Granite Slope Dr
Sandy, UT 84092-6004
Phone (801) 943-0970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071129000120 UT Practitioner - Optometry 8224127279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyemax Eyecare, PLLC.Group PAC ID 2668529934, 2 clinicians

Practice addresses (Care Compare)

166 E 5900
Suite B103
Murray, UT 84107-7278
Phone (801) 268-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyemax Eyecare, PLLC. Optometrist CurrentSince Oct 1, 2011 Accepting new patients
Eagle Eye Care, Inc. Optometrist PastSince Oct 29, 2007 Accepting new patients

Locations

166 E 5900 S
Ste B103
Salt Lake Cty, UT 84107
Phone (801) 262-3395

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1730390261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9862 GRANITE SLOPE DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840926004",
            "telephone_number": "801-943-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E 5900 S",
            "address_2": "SUIT B103",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077257",
            "telephone_number": "801-268-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOSEPH",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "111309-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.