Individual provider Active NPI

Ann Marie Martinek, MD

  • Retina Specialist (Ophthalmology) Physician
  • Dayton, OH
National Provider Identifier
1912904467
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
35069885 Issued in OH
Practice address
89 Sylvania Dr
2ND FL
Dayton, OH 45440-3237
Phone
(937) 427-8900
Fax
(937) 427-1710
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301057520 MI
Ophthalmology Physician 207W00000X 35069885 OH
Retina Specialist (Ophthalmology) Physician 207WX0107X 4301057520 MI
Retina Specialist (Ophthalmology) Physician 207WX0107X 35069885 OH Primary

Addresses

Primary practice location

89 Sylvania Dr
2ND FL
Dayton, OH 45440-3237

Mailing address

89 Sylvania Dr
2ND FL
Dayton, OH 45440-3237
Phone (937) 427-8900

Other identifiers 1

IdentifierTypeStateIssuer
0284839MedicaidOH

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

LicenseStateTypeSpecialty
4301057520MIMDRetina Specialist (Ophthalmology) Physician
35069885OHMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1912904467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "address_2": "2ND FL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403237",
            "telephone_number": "937-427-8900",
            "fax_number": "937-427-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "address_2": "2ND FL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403237",
            "telephone_number": "937-427-8900",
            "fax_number": "937-427-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEK",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301057520",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35069885",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MI",
            "license": "4301057520",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OH",
            "license": "35069885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0284839",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.