Kevin Martin, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

219540 Issued in NY

Practice address

30 Crescent Ave
Saratoga Springs, NY 12866-5142

Phone

(518) 584-3600

Fax

(518) 584-3235

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Professional Medical Concierge Services, PLLC

  • Family Medicine Physician
  • Saratoga Springs, NY
  • NPI 1841812310
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750488862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HARVEST LN",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128312530",
            "telephone_number": "518-584-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CRESCENT AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665142",
            "telephone_number": "518-584-3600",
            "fax_number": "518-584-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "219540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01047290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Marinucci, LMSW
• Kimberly A Mariotti, PTA
• Marisa Wolff DO PLLC
• Marker 28 LLC
• Kimberly L Marks, LCSW
• Michael Martin, PSYD
• Martins Foods of South Burlington LLC
• Maryam Hariri
• Jennifer Szymanski Mashaw, PT
• Erica Masterson, MS RD CDN

• Child & Adolescent Psychiatry Physician in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.