Individual provider Active NPI

Andrew Lee Martin, PSY.D.

  • Clinical Psychologist
  • Newport News, VA
National Provider Identifier
1780674820
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6808 Issued in FL
Practice address
250 Nat Turner Blvd S
Newport News, VA 23606-3074
Phone
(757) 596-1900
Fax
(866) 420-0168
NPI assigned
Oct 27, 2005
Last updated
Nov 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6808 FL Primary

Addresses

Primary practice location

250 Nat Turner Blvd S
Newport News, VA 23606-3074

Mailing address

250 Nat Turner Blvd S
Newport News, VA 23606-3074
Phone (757) 596-1900

Other practice location 1

1 Boone Rd
Bremerton, WA 98312-1894
Phone (360) 475-4426

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201116002706 VA Practitioner - Clinical Psychologist 1951712397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Nova Southeastern College of Osteo Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

250 Nat Turner Blvd S
Newport News, VA 23606-3074
Phone (757) 596-1900

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
84.93
Promoting interoperability
98
Improvement activities
40
Cost
64.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY6808FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Surgery and Sports Medicine Specialists CurrentSince Jan 1, 2021 Accepting new patients
Orthopaedic Surgery & Sports Med Specialist of Hampton RDS PC CurrentSince Jan 1, 2021 Accepting new patients

Locations

250 Nat Turner Blvd S
Newport News, VA 23606
Phone (757) 596-1900

Interoperability endpoints

  • Direct secure messaging: andrew.martin.p1@direct.osc-ortho.nextgenshare.com

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1780674820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063074",
            "telephone_number": "757-596-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063074",
            "telephone_number": "757-596-1900",
            "fax_number": "866-420-0168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boone Rd",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "983121894",
            "country_code": "US",
            "telephone_number": "360-475-4426",
            "fax_number": "360-475-4434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANDREW",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.