Active NPI
Sara Jean Martin, M.D.
- Family Medicine Physician
- Sauk Centre, MN
National Provider Identifier
1891087276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 55408
- Practice address
- 12099 Alcott Dr
Sauk Centre, MN 56378-4744 - Phone
- (320) 267-3479
- NPI assigned
- May 4, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 55408 | MN | Primary |
Addresses
Primary practice location
12099 Alcott Dr
Sauk Centre, MN 56378-4744
Mailing address
12099 Alcott Dr
Sauk Centre, MN 56378-4744
Phone (320) 267-3479
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891087276 | Medicaid | MN | |
| P01099796 | Other | RR MEDICARE | |
| 0001-0100298 | Other | MEDICA | |
| 1891087276 | Other | MN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 24, 2022 through May 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625875200000",
"number": "1891087276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12099 ALCOTT DR",
"city": "SAUK CENTRE",
"state": "MN",
"postal_code": "563784744",
"telephone_number": "320-267-3479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12099 ALCOTT DR",
"city": "SAUK CENTRE",
"state": "MN",
"postal_code": "563784744",
"telephone_number": "320-267-3479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SARA",
"middle_name": "JEAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-04",
"last_updated": "2021-07-10",
"certification_date": "2021-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "55408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891087276",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01099796",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0001-0100298",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1891087276",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sauk Centre, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.