Active NPI
Robert J Martin, M.D.
- Dermatology Physician
- Puyallup, WA
National Provider Identifier
1912013814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD00014963
- Practice address
- 1703 S Meridian
Suite 101
Puyallup, WA 98371 - Phone
- (253) 848-3000
- Fax
- (253) 840-6514
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD00014963 | WA | Primary |
Addresses
Primary practice location
1703 S Meridian
Suite 101
Puyallup, WA 98371
Mailing address
1703 S Meridian
Suite 101
Puyallup, WA 98371
Phone (253) 848-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1071703 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00014963 | WA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Eye & Skin Centers P.C. | Dermatology | Past | Accepting new patients |
| Cascade Eye & Skin Centers PC | Dermatology | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912013814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 S MERIDIAN",
"address_2": "SUITE 101",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "98371",
"telephone_number": "253-848-3000",
"fax_number": "253-840-6514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 S MERIDIAN",
"address_2": "SUITE 101",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "98371",
"telephone_number": "253-848-3000",
"fax_number": "253-840-6514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "MD00014963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1071703",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.