Individual provider Active NPI

George L Martin, M.D.

  • Urology Physician
  • Fort Wayne, IN
National Provider Identifier
1841222452
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01071495A Issued in IN
Practice address
11141 Parkview Plaza Dr Ste 325
Fort Wayne, IN 46845-1714
Phone
(260) 425-5400
Fax
(260) 425-5417
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 37370 AZ
Urology Physician 208800000X 01071495A IN Primary

Addresses

Primary practice location

11141 Parkview Plaza Dr Ste 325
Fort Wayne, IN 46845-1714

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other identifiers 4

IdentifierTypeStateIssuer
201081540MedicaidIN
000000776371OtherINANTHEM
370244MedicaidAZ
P00869313OtherAZRAILROAD MEDICARE

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address gmartin65254@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

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
I20120809000200 IN Practitioner - Urology 5092873042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Indiana University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System Inc 1,350 clinicians

Practice addresses (Care Compare)

11050 Parkview Circle Dr
Fort Wayne, IN 46845-1739
Phone (260) 266-2800

Hospital & facility affiliations

  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330
  • Community Hospitals and Wellness Centers Hospital, Bryan, OH, CCN 360121
  • Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101
  • Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37370AZMDUrology Physician
01071495AINMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System, Inc. Urology CurrentSince Jun 3, 2020 Accepting new patients
St Joseph Medical Group Inc CurrentSince Feb 1, 2015 Accepting new patients
Parkview Health System Inc Current Accepting new patients
St Joseph Medical Group Inc CurrentSince Feb 1, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

11050 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 266-7100

11141 Parkview Plaza Dr
Ste 325
Fort Wayne, IN 46845
Phone (260) 425-5400

3702 New Vision Dr
Bldg B
Fort Wayne, IN 46845
Phone (260) 266-8210

1818 Carew St
Ste 210
Fort Wayne, IN 46805
Phone (260) 425-5400

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

2622 Lake Ave
Fort Wayne, IN 46805
Phone (260) 425-3100

800 Broadway
Ste 315
Fort Wayne, IN 46802
Phone (260) 422-7427

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

2512 E DuPont Rd
Ste 100
Fort Wayne, IN 46825
Phone (260) 347-4459

800 Broadway
Ste 204
Fort Wayne, IN 46802
Phone (260) 420-4884

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

140 Fox Rd
Ste 404
Van Wert, OH 45891
Phone (419) 238-2476

Interoperability endpoints

  • Direct secure messaging: gmartin65254@direct.parkviewexchange.com

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.

Hospital & facility affiliations 6

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1841222452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR STE 325",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451714",
            "telephone_number": "260-425-5400",
            "fax_number": "260-425-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GEORGE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "37370",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01071495A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201081540",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000776371",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370244",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00869313",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmartin65254@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 325",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 325",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 325",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.