Mark R St. Martin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301082441 Issued in MI

Practice address

26850 Providence Pkwy
Suite 505
Novi, MI 48374-1209

Phone

(248) 465-4163

Fax

(248) 465-4359

NPI assigned

Mar 29, 2006

Last updated

Nov 10, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mstmartin1152198@direct.hfhs.org

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.

• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1922063213
  NPD
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health System

  dba Henry Ford West Bloomfield Hospital

  • General Acute Care Hospital
  • West Bloomfield, MI
  • NPI 1407867559
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1922069061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "SUITE 505",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741209",
            "telephone_number": "248-465-4163",
            "fax_number": "248-465-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "SUITE 505",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741209",
            "telephone_number": "248-465-4163",
            "fax_number": "248-465-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. MARTIN",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301082441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4883284",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Squires, PA-C
• Hady H Srour, OD
• Sandra St Clair
• Nelson St. Fleur
• Shannon St. John
• Tumar Stachura
• Laurie Stadther
• Amber Stagg
• Courtney Stakenas
• Grace Aluia Stalions

• Internal Medicine Physician in Novi, MI
• Providers in Novi, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.