Individual provider Active NPI

William Charles Martin, MD

  • Anesthesiology Physician
  • Grand Junction, CO
National Provider Identifier
1922062371
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
38178 Issued in CO
Practice address
2021 N 12TH St
Grand Junction, CO 81501-2980
Phone
(970) 254-1686
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 38178 CO Primary

Addresses

Primary practice location

2021 N 12TH St
Grand Junction, CO 81501-2980

Mailing address

2754 Compass Dr
Suite 300
Grand Junction, CO 81506-8714
Phone (970) 254-1686

Other identifiers 2

IdentifierTypeStateIssuer
02504278MedicaidCO
T0201MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918003636 HI Practitioner - Anesthesiology 2769552983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.97 of 100Reported as group
Quality
82.79
Improvement activities
40
Cost
76.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38178COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia Hawaii, LLC Anesthesiology CurrentSince Aug 21, 2019 Accepting new patients
Anesthesia Partners of Montana PC Past Accepting new patients

Locations

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1922062371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2754 COMPASS DR",
            "address_2": "SUITE 300",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068714",
            "telephone_number": "970-254-1686",
            "fax_number": "970-254-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012980",
            "telephone_number": "970-254-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WILLIAM",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "38178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02504278",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0201",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.