Individual provider Active NPI

Thomas Patrick Martin Jr., MD

  • Emergency Medicine Physician
  • Mt Pleasant, SC
National Provider Identifier
1811982960
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD044453E Issued in PA
Practice address
1528 Red Tide Rd
Mt Pleasant, SC 29466-9406
Phone
(412) 427-5688
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD044453E PA Primary

Addresses

Primary practice location

1528 Red Tide Rd
Mt Pleasant, SC 29466-9406

Mailing address

1528 Red Tide Rd
Mt Pleasant, SC 29466-9406
Phone (412) 427-5688

Other identifiers 3

IdentifierTypeStateIssuer
3004639000MedicaidWV
2768401MedicaidOH
0012340960006MedicaidPA

Other names 1

  • Thomas Patrick Martin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, SC, TN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170828002295 AL Practitioner - Emergency Medicine 3173664539 Reassigns benefits to 2 organizations
I20180718003826 SC Practitioner - Emergency Medicine 3173664539 Reassigns benefits to 2 organizations
I20180817000951 TN Practitioner - Emergency Medicine 3173664539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Harvard Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

2000 Hospital Dr
Mt Pleasant, SC 29464-3764
Phone (843) 881-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD044453EPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hilton Head Emergency Physicians, Inc. Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Hilton Head Emergency Physicians, LLC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Aug 21, 2018 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Emergency Services of Montgomery PC Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jun 11, 2018 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
West Penn Allegheny Health System, Inc. Past Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1811982960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 RED TIDE RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669406",
            "telephone_number": "412-427-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 RED TIDE RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669406",
            "telephone_number": "412-427-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "THOMAS",
        "middle_name": "PATRICK",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD044453E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004639000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2768401",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012340960006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "MARTIN",
            "middle_name": "PATRICK",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.