Individual provider Active NPI

Matthew S. Martin

  • Emergency Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1932361425
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0056638 Issued in CO
Practice address
1024 S Lemay Ave
Fort Collins, CO 80524-3929
Phone
(970) 495-7000
Fax
(303) 306-7753
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT193722 PA
Emergency Medicine Physician 207P00000X 61521-20 WI
Emergency Medicine Physician 207P00000X DR.0056638 CO Primary

Addresses

Primary practice location

1024 S Lemay Ave
Fort Collins, CO 80524-3929

Mailing address

PO Box 912215
Denver, CO 80291-2215
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
DR.0056638OtherCOCOLORADO MEDICAL LICENSE

Other names 1

  • Matthew S. Martin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160818002101 CO Practitioner - Emergency Medicine 5395998710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.04 of 100Reported as group
Quality
87.35
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0056638COMDEmergency Medicine Physician
MT193722PAMDEmergency Medicine Physician
61521-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of the Rockies, PC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Emergency Physicians of the Rockies, PC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1932361425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912215",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912215",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243929",
            "telephone_number": "970-495-7000",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MATTHEW",
        "middle_name": "S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT193722",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "61521-20",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0056638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO MEDICAL LICENSE",
            "identifier": "DR.0056638",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "MARTIN",
            "middle_name": "S.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.