Individual provider Active NPI

Andrew Martina

  • Psychiatry Physician
  • Providence, RI
National Provider Identifier
1891157442
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD17927 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-4779
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X 283114 MA
Psychiatry Physician 2084P0800X MD17927 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200817000619 MA Practitioner - Psychiatry 7618227687 Reassigns benefits to 2 organizations
I20210915001199 RI Practitioner - Psychiatry 7618227687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albany Medical College of Union University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

180 Corliss St
Suite E1
Providence, RI 02904-2602
Phone (401) 793-2928

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-6779

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital Psychiatry CurrentSince Sep 1, 2021 Accepting new patients
The Miriam Hospital CurrentSince Sep 1, 2021 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jul 1, 2020 Accepting new patients
The McLean Hospital Corporation Psychiatry CurrentSince May 20, 2024 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Lifespan Physician Group, Inc. Psychiatry CurrentSince Sep 1, 2021 Accepting new patients
The McLean Hospital Corporation Past Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

180 Corliss St
Ste E1
Providence, RI 02904
Phone (401) 793-2928

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

1125 N Main St
Providence, RI 02904
Phone (401) 793-2928

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

Interoperability endpoints

  • Direct secure messaging: martina.andrew.mcl@direct.partners.masshiway.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1891157442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINA",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2021-09-14",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MA",
            "license": "283114",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD17927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.