Individual provider Active NPI

Ciro Kirk Demartino, M.D.

  • Family Medicine Physician
  • Marco Island, FL
National Provider Identifier
1780687467
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 85819 Issued in FL
Practice address
950 N Collier Blvd
Ste 308
Marco Island, FL 34145-2722
Phone
(239) 642-5552
Fax
(239) 642-5565
NPI assigned
May 24, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 ME 85819 FL Primary

Addresses

Primary practice location

950 N Collier Blvd
Ste 308
Marco Island, FL 34145-2722

Mailing address

950 N Collier Blvd
Ste 308
Marco Island, FL 34145-2722
Phone (239) 642-5552

Other identifiers 1

IdentifierTypeStateIssuer
79208OtherFLBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040105000844 FL Practitioner - Family Practice 6709785116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

950 N Collier Blvd
Suite 308
Marco Island, FL 34145-2722

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 85819FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C. Kirk Demartino M.D. PA Family Medicine CurrentSince Sep 1, 2003 Accepting new patients

Locations

950 N Collier Blvd
Ste 308
Marco Island, FL 34145
Phone (239) 642-5552

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780687467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N COLLIER BLVD",
            "address_2": "STE 308",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452722",
            "telephone_number": "239-642-5552",
            "fax_number": "239-642-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N COLLIER BLVD",
            "address_2": "STE 308",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452722",
            "telephone_number": "239-642-5552",
            "fax_number": "239-642-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARTINO",
        "first_name": "CIRO",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 85819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "79208",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marco Island, FL

Sources for this page

Verify at the official NPI Registry.