NPIMap

Organization Active NPI

Martin Primary Care LLC

  • Internal Medicine Physician
  • Stuart, FL
National Provider Identifier
1790934909
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME85669 Issued in FL
Legal business name
MARTIN PRIMARY CARE LLC
Practice address
3257 SE Salerno Rd
Stuart, FL 34997
Phone
(772) 287-9143
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Dr. Ahmad Fadel, M.D.NPI 1285640169
Title
Physician
Phone
(772) 287-9143

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME85669 FL Primary

Addresses

Primary practice location

3257 SE Salerno Rd
Stuart, FL 34997

Mailing address

PO Box 592
Jupiter, FL 33468
Phone (772) 287-9143

Other identifiers 1

IdentifierTypeStateIssuer
000578800MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Martin Primary Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1001 SE Ocean Blvd
Ste 101
Stuart, FL 34996
Phone (407) 286-1990

1001 SE Ocean Blvd
Ste 103C
Stuart, FL 34996
Phone (772) 287-9143

Practitioners & affiliated clinicians

Practitioners 3

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": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1790934909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 592",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33468",
            "telephone_number": "772-287-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34997",
            "telephone_number": "772-287-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "FADEL",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "772-287-9143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME85669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000578800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.