Sandra L Martin, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71001851A Issued in IN

Practice address

100 Navarre PL
Suite 6600
South Bend, IN 46601-1156

Phone

(574) 232-7227

Fax

(574) 232-2064

NPI assigned

Nov 16, 2005

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5893/brand/1/csg/1/fhir/r4
• Direct secure messaging: smartin1158562@direct.trinity-health.org
• Direct secure messaging: smartin4@mybeacon.cernerdirect.com

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.

• Elite Emergency Physicians Inc

  • Emergency Medicine Physician
  • Elkhart, IN
  • NPI 1932155371
  Medicare reassignment NPD
• Kidney Care of Michiana LLC

  • Nephrology Physician
  • Mishawaka, IN
  • NPI 1093067530
  Medicare reassignment NPD
• Ajit V Pai MD

  • Interventional Pain Medicine Physician
  • Mishawaka, IN
  • NPI 1376578310
  NPD (past)
• Mohci Urgent Care LLC

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1457398018
  NPD (past)
• William E Paul DDS PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • South Bend, IN
  • NPI 1285662163
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1851373898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL",
            "address_2": "SUITE 6600",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011156",
            "telephone_number": "574-232-7227",
            "fax_number": "574-232-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SANDRA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001851A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000742868",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200303930",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "352145705",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smartin4@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Navarre Pl",
            "address_2": "Suite 6600",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah L Martin-Stoldt, NP
• Christina Martin
• Erica Lyn Martin, M.D.
• Leah Murugi Martin, FNP
• Peter Ray Martin, MD
• Stephanie Martin, MSOT, OTR
• Sarah Marting
• Gevorg Martirosyan, PHARMD
• Mary Free Bed Orthotics and Prosthetics
• Mary Free Bed Orthotics and Prosthetics

• Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.