Individual provider Active NPI

Nicholas Darryl Martin, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1902425887
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12739800 Issued in NJ
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(212) 305-6354
NPI assigned
Apr 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 321305 NY
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 25MA12739800 NJ Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

630 W 168TH St # 4
New York, NY 10032-3725

Other practice location 1

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (212) 662-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20230718002263 NY Practitioner - Internal Medicine 6507249026 Reassigns benefits to 1 organization
I20250821002064 NJ Practitioner - Internal Medicine 6507249026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rutgers RWJ Eric B. Chandler Health CenterGroup PAC ID 0042111601, 27 clinicians
Rutgers Health-RWJ Primary Medicine GroupGroup PAC ID 7911972674, 42 clinicians

Practice addresses (Care Compare)

123 Church St
New Brunswick, NJ 08901-2001
Phone (732) 235-6700

125 Paterson St
New Brunswick, NJ 08901-1962
Phone (732) 235-6968

277 George St
New Brunswick, NJ 08901-1311

277 George St
New Brunswick, NJ 08901-1476
Phone (732) 235-6700

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038
  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
321305NYMDLicensed Practical Nurse
25MA12739800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jun 28, 2023 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Internal Medicine Current Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Current Accepting new patients
Rutgers RWJ Eric B. Chandler Health Center CurrentSince Aug 1, 2025 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Internal Medicine CurrentSince Jun 7, 2025 Accepting new patients
Rutgers RWJ Eric B. Chandler Health Center Current Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jun 28, 2023 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group CurrentSince Jun 7, 2025 Accepting new patients
Rutgers RWJ Eric B. Chandler Health Center CurrentSince Aug 1, 2025 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

123 Church St
New Brunswick, NJ 08901
Phone (732) 235-2052

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

277 George St
New Brunswick, NJ 08901
Phone (732) 235-6700

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1 Worlds Fair Dr
Fl 1
Somerset, NJ 08873
Phone (732) 235-7894

66 W Gilbert St
Ste 200
Tinton Falls, NJ 07701
Phone (732) 212-0051

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://api.platform.athenahealth.com/24297/brand/1/csg/1/fhir/r4
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: glj9012@direct.nyp.org

Organizations & group practices 10

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1902425887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-6354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044238",
            "country_code": "US",
            "telephone_number": "212-662-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NICHOLAS",
        "middle_name": "DARRYL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "321305",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12739800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.