Individual provider Active NPI

Clay Douglas Martin, MD

  • Urology Physician
  • Wilmington, NC
National Provider Identifier
1912494576
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2023-01846 Issued in NC
Practice address
1124 Gallery Park LN
Wilmington, NC 28412-1142
Phone
(910) 341-3389
Fax
(910) 815-3144
NPI assigned
Apr 19, 2018
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2023-01846 NC Primary

Addresses

Primary practice location

1124 Gallery Park LN
Wilmington, NC 28412-1142

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230831000740 NC Practitioner - Urology 8224372123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Medical School at Houston, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1124 Gallery Park LN
Wilmington, NC 28412-1142
Phone (910) 341-1540

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince Aug 22, 2023 Accepting new patients
Wilmington Health PLLC CurrentSince Aug 22, 2023 Accepting new patients

Locations

1124 Gallery Park Ln
Wilmington, NC 28412
Phone (910) 341-3389

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

8090 Market St
Wilmington, NC 28411
Phone (910) 251-6737

Interoperability endpoints

  • Direct secure messaging: clay.martin.p1@direct.wilmingtonhealth.nextgenshare.com
  • Direct secure messaging: cmartin1466556@direct.novanthealth.org

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.

Hospital & facility affiliations 1

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1912494576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-1540",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 GALLERY PARK LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121142",
            "telephone_number": "910-341-3389",
            "fax_number": "910-815-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CLAY",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2023-01846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.