Individual provider Active NPI

Ronald T Martin, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Carmel, IN
National Provider Identifier
1790783561
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
1034381 Issued in IN
Practice address
11220 Illinois St Ste 220
Carmel, IN 46032-9847
Phone
(317) 817-1976
Fax
(317) 817-1737
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 1034381 IN Primary
Ophthalmology Physician 207W00000X 1034381 IN

Addresses

Primary practice location

11220 Illinois St Ste 220
Carmel, IN 46032-9847

Mailing address

11220 Illinois St Ste 220
Carmel, IN 46032-9847
Phone (317) 817-1976

Other identifiers 1

IdentifierTypeStateIssuer
200060730MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20101113000006 IN Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 2062512510 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1034381INMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Plastic Surgery Inc Ophthalmology CurrentSince Jul 28, 1976 Accepting new patients
Major Hospital Ophthalmology Past Accepting new patients

Locations

201 Pennsylvania Pkwy
Carmel, IN 46280
Phone (317) 817-1254

10300 N Illinois St
Ste 2020
Carmel, IN 46290
Phone (317) 817-1973

11220 Illinois St
Ste 220
Carmel, IN 46032

7920 W Jefferson Blvd
Ste 230
Fort Wayne, IN 46804
Phone (260) 432-7600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1790783561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 ILLINOIS ST STE 220",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329847",
            "telephone_number": "317-817-1976",
            "fax_number": "317-817-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 ILLINOIS ST STE 220",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329847",
            "telephone_number": "317-817-1976",
            "fax_number": "317-817-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RONALD",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "IN",
            "license": "1034381",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "1034381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200060730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.