Active NPI
Jesse Martin, DO
- Vascular & Interventional Radiology Physician
- Myrtle Beach, SC
National Provider Identifier
1932668787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 93625
- Practice address
- 809 82ND Pkwy
Myrtle Beach, SC 29572-4607 - Phone
- (843) 692-1000
- NPI assigned
- Mar 19, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 93625 | SC | Primary |
Addresses
Primary practice location
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Mailing address
PO Box 678904
Dallas, TX 75267-8904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- 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
- Diagnostic Radiology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1916
Hospital & facility affiliations
- Grand Strand Regional Medical Center
- McLeod Loris Hospital
- Conway Medical Center
- McLeod Regional Medical Center-Pee Dee
- Tidelands Waccamaw Community Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 11 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93625 | SC | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Musc Community Physicians | Current | Accepting new patients | |
| Musc Community Physicians | Current | Accepting new patients | |
| Carolina Radiology Associates LLC | Vascular & Interventional Radiology | Current | Accepting new patients |
| Musc Community Physicians | Current | Accepting new patients |
Locations
506 North St
Bamberg, SC 29003
Phone (803) 245-6290
805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500
3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000
809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Conway, SC
- NPI 1225014657
Vascular & Interventional Radiology
-
- Internal Medicine Physician
- Bamberg, SC
- NPI 1841878006
-
- Rural Health Clinic/Center
- Bowman, SC
- NPI 1225735772
-
- Family Medicine Physician
- Bamberg, SC
- NPI 1992383145
Hospital & facility affiliations 17
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Conway, SC
- NPI 1134172000
-
- Rehabilitation Hospital Unit
- Conway, SC
- NPI 1154991487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751760000000",
"number": "1932668787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 678904",
"city": "DALLAS",
"state": "TX",
"postal_code": "752678904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 82ND PKWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724607",
"telephone_number": "843-692-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JESSE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-19",
"last_updated": "2025-07-06",
"certification_date": "2025-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "SC",
"license": "93625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2025; 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.