Individual provider Active NPI

Benjamin Donahue Martin, M.D.

  • Orthopaedic Surgery Physician
  • Washington, DC
National Provider Identifier
1801068929
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
149984 Issued in DC
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(202) 476-4063
Fax
(202) 476-4613
NPI assigned
Mar 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0116017285 VA
Orthopaedic Surgery Physician 207X00000X 149984 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-4063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111123000539 DC Practitioner - Pediatric MedicinePractitioner - Orthopedic Surgery 0840464160 Reassigns benefits to 2 organizations
I20151203002290 VA Practitioner - Pediatric MedicinePractitioner - Gastroenterology 0840464160 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149984DCMDOrthopaedic Surgery Physician
0116017285VAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Sep 26, 2011 Accepting new patients
Children'S Hospital Current Accepting new patients
Oklahoma Physical Therapy Choctaw Current Accepting new patients
Children'S Hospital CurrentSince Sep 26, 2011 Accepting new patients
Pediatric Specialists of Virginia, LLC CurrentSince Feb 17, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

3023 Hamaker Ct
Ste 500
Fairfax, VA 22031
Phone (571) 766-3137

14904 Richmond Hwy
Woodbridge, VA 22191
Phone (703) 492-6660

Interoperability endpoints

  • Direct secure messaging: bmartin102130@soc.inova.org

Organizations & group practices 6

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": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1801068929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-4063",
            "fax_number": "202-476-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-4063",
            "fax_number": "202-476-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BENJAMIN",
        "middle_name": "DONAHUE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-28",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0116017285",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DC",
            "license": "149984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.