Active NPI
Susan G Martin, FNP-C
- Family Nurse Practitioner
- Buffalo, NY
National Provider Identifier
1770663734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP081535
- Practice address
- 155 Lawn Ave
Buffalo, NY 14207-1816 - Phone
- (716) 875-2904
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP081535 | ME | Primary |
Addresses
Primary practice location
155 Lawn Ave
Buffalo, NY 14207-1816
Mailing address
155 Lawn Ave
Buffalo, NY 14207-1816
Phone (716) 875-2904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432097699 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
77 Park St
Rockland, ME 04841-2846
Phone (800) 683-8313
849 Stillwater Ave
Bangor, ME 04401-3624
Phone (800) 683-8313
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP081535 | ME | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recover Together, LLC | Family | Current | Accepting new patients |
| Recover Together, Inc. | Family | Current | Accepting new patients |
| Portland Opioid Health Home | Past | Accepting new patients | |
| Constance W Jordan Anp Pmhnp PLLC | Past | Accepting new patients |
Locations
Dept CH17590
Palatine, IL 60055
77 Park St
Rockland, ME 04841
Phone (207) 245-7654
Organizations & group practices 4
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.
-
- Clinic/Center
- Cape Elizabeth, ME
- NPI 1770365272
-
- Addiction (Substance Use Disorder) Counselor
- Portland, ME
- NPI 1841855301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1770663734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 LAWN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142071816",
"telephone_number": "716-875-2904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 LAWN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142071816",
"telephone_number": "716-875-2904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SUSAN",
"middle_name": "G",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ME",
"license": "AP081535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432097699",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.