Individual provider Active NPI

Tracey L Martin, MD

  • Family Medicine Physician
  • Tempe, AZ
National Provider Identifier
1770589491
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27302 Issued in AZ
Practice address
4515 S McClintock Dr
Ste 100
Tempe, AZ 85282-7381
Phone
(480) 820-1133
Fax
(480) 820-9292
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27302 AZ Primary

Addresses

Primary practice location

4515 S McClintock Dr
Ste 100
Tempe, AZ 85282-7381

Mailing address

4515 S McClintock Dr
Ste 100
Tempe, AZ 85282-7381
Phone (480) 820-1133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20101026000366 AZ Practitioner - Family Practice 7517159767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Valley Primary Care Physicians PLCGroup PAC ID 2860471893, 4 clinicians

Practice addresses (Care Compare)

4515 S McClintock Dr
Suite 100
Tempe, AZ 85282-7381
Phone (480) 820-1133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
25.44 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
64.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Primary Care Physicians PLC CurrentSince Oct 15, 2002 Accepting new patients

Locations

4515 S McClintock Dr
Ste 100
Tempe, AZ 85282
Phone (480) 820-1133

Organizations & group practices 1

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 2

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1770589491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR",
            "address_2": "STE 100",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-820-1133",
            "fax_number": "480-820-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR",
            "address_2": "STE 100",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-820-1133",
            "fax_number": "480-820-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TRACEY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "27302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.