Individual provider Active NPI

Martha L Ducatel, D.M.D.

  • General Practice Dentistry
  • Brandon, FL
National Provider Identifier
1871804203
Registry record updated Feb 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 19076 Issued in FL
Practice address
3415 Brook Crossing Dr
Brandon, FL 33511-8181
Phone
(813) 540-5005
NPI assigned
Jun 30, 2010
Last updated
Feb 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 19076 FL Primary

Addresses

Primary practice location

3415 Brook Crossing Dr
Brandon, FL 33511-8181

Mailing address

3415 Brook Crossing Dr
Brandon, FL 33511-8181
Phone (813) 540-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160323000587 FL Order and Referring Only - DentistPractitioner - Dentist 4688971443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 19076FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Bodies Medical Center Past Accepting new patients

Organizations & group practices 2

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486771200000",
    "number": "1871804203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 BROOK CROSSING DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118181",
            "telephone_number": "813-540-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BROOK CROSSING DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118181",
            "telephone_number": "813-540-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCATEL",
        "first_name": "MARTHA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2017-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 19076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.