Individual provider Active NPI

Brenda Ann Martin, M.D.

  • Gynecology Physician
  • West Babylon, NY
National Provider Identifier
1821255621
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
320354 Issued in NY
Practice address
580 Sunrise Hwy
West Babylon, NY 11704-6000
Phone
(631) 422-9355
Fax
(631) 669-8763
NPI assigned
May 20, 2008
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4036 AZ
Obstetrics & Gynecology Physician 207V00000X LP00744 RI
Gynecology Physician 207VG0400X 320354 NY Primary

Addresses

Primary practice location

580 Sunrise Hwy
West Babylon, NY 11704-6000

Mailing address

580 Sunrise Hwy
West Babylon, NY 11704-6000
Phone (631) 422-9355

Other identifiers 1

IdentifierTypeStateIssuer
370950MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230413000432 NY Practitioner - Obstetrics/Gynecology 5193891158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4036AZMDFamily Medicine Physician
LP00744RIMDObstetrics & Gynecology Physician
320354NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 1, 2023 Accepting new patients
New York University Obstetrics & Gynecology CurrentSince May 1, 2023 Accepting new patients
Shea Womens Care PC Obstetrics & Gynecology Past Accepting new patients
Southwest Spine and Sports Past Accepting new patients

Locations

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

580 Sunrise Hwy
West Babylon, NY 11704
Phone (631) 321-0011

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: bmartin573926@nyumc.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1821255621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 SUNRISE HWY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046000",
            "telephone_number": "631-422-9355",
            "fax_number": "631-669-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 SUNRISE HWY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046000",
            "telephone_number": "631-422-9355",
            "fax_number": "631-669-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "4036",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "LP00744",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "320354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370950",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

Verify at the official NPI Registry.