Active NPI
Jonathan Vasilios Saguan Martin, M.D.
- Surgery Physician
- Stony Brook, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 315942
- Practice address
- 101 Nicolls Rd
Stony Brook, NY 11794-2874 - Phone
- (631) 444-8329
- Fax
- (631) 444-6176
- NPI assigned
- May 3, 2013
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Critical Care Physician | 2086S0102X | 315942 | NY | |
| Surgical Critical Care Physician | 2086S0102X | 71089 | MN | |
| Surgical Critical Care Physician | 2086S0102X | 4301103306 | MI | |
| Surgery Physician | 208600000X | 4301103306 | MI | |
| Surgical Critical Care Physician | 2086S0102X | 65407 | AZ | |
| Trauma Surgery Physician | 2086S0127X | 315942 | NY | |
| Surgery Physician | 208600000X | 315942 | NY | Primary |
Addresses
Primary practice location
101 Nicolls Rd
Stony Brook, NY 11794-2874
Mailing address
1452 Robert Bradby Dr Apt B
Detroit, MI 48207-4923
Phone (530) 401-4248
Other practice location 1
1406 6th Ave N
Saint Cloud, MN 56303-1900
Phone (320) 240-2836
Other practice location 2
5301 E Grant Rd
Tucson, AZ 85712-2874
Phone (520) 324-1127
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Loma Linda University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65407 | AZ | MD | Surgical Critical Care Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Surgical Associates, University Faculty Practice Corporati | Surgery | Current | Accepting new patients |
| University Hospital at Stony Brook | Past | Accepting new patients |
Locations
37 Research Way
Rm 46B
East Setauket, NY 11733
37 Research Way
Setauket, NY 11733
Phone (631) 444-4121
101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- jmartin618906@direct.centracare.com
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.
-
- Surgery Physician
- Stony Brook, NY
- NPI 1063468536
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1922443019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1452 ROBERT BRADBY DR APT B",
"city": "DETROIT",
"state": "MI",
"postal_code": "482074923",
"telephone_number": "530-401-4248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 NICOLLS RD",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117942874",
"telephone_number": "631-444-8329",
"fax_number": "631-444-6176"
}
],
"practiceLocations": [
{
"address_1": "1406 6th Ave N",
"address_purpose": "LOCATION",
"city": "Saint Cloud",
"state": "MN",
"postal_code": "563031900",
"country_code": "US",
"telephone_number": "320-240-2836",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5301 E Grant Rd",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857122874",
"country_code": "US",
"telephone_number": "520-324-1127",
"fax_number": "520-324-2051",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "JONATHAN",
"middle_name": "VASILIOS SAGUAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-03",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "NY",
"license": "315942",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "MN",
"license": "71089",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "MI",
"license": "4301103306",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301103306",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "AZ",
"license": "65407",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "NY",
"license": "315942",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "315942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.