NPIMap

Organization Active NPI

Wayne H. Martin, M.D., Inc.

  • Ophthalmology Physician
  • Diamond Bar, CA
National Provider Identifier
1770749525
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WAYNE H. MARTIN, M.D., INC.
Practice address
1111 Grand Ave
Suite a
Diamond Bar, CA 91765-4171
Phone
(909) 860-6768
Fax
(909) 860-4224
NPI assigned
Jul 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Authorized official

Name
Wayne H. Martin, M.D.NPI 1033293261
Title
President
Phone
(909) 860-6768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1111 Grand Ave
Suite a
Diamond Bar, CA 91765-4171

Mailing address

1111 Grand Ave
Suite a
Diamond Bar, CA 91765-4171
Phone (909) 860-6768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000586 CA Part B Supplier - Clinic/Group Practice 0042113375 Receives reassigned benefits from 7 practitioners
Practice locations: Chino, CA; Diamond Bar, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: wmartin@wmartin.intellechartdirect.net
  • Direct secure messaging: nnguyen@wmartin.intellechartdirect.net
  • Direct secure messaging: ezhang@wmartin.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255046400000",
    "number": "1770749525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GRAND AVE",
            "address_2": "SUITE A",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654171",
            "telephone_number": "909-860-6768",
            "fax_number": "909-860-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GRAND AVE",
            "address_2": "SUITE A",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654171",
            "telephone_number": "909-860-6768",
            "fax_number": "909-860-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE H. MARTIN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2009-10-09",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-860-6768",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.