Individual provider Active NPI

Nathaniel Alexander Martin IV, OD

  • Optometrist
  • Sanford, NC
National Provider Identifier
1952393035
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1737 Issued in NC
Practice address
405 E Main St
Sanford, NC 27332-6119
Phone
(919) 776-1012
Fax
(919) 775-3420
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1737 NC Primary

Addresses

Primary practice location

405 E Main St
Sanford, NC 27332-6119

Mailing address

405 E Main St
Sanford, NC 27332-6119
Phone (919) 776-1012

Other identifiers 1

IdentifierTypeStateIssuer
018AKOtherNCBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000309 NC Practitioner - Optometry 4880665215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision One Eye Center OD PAGroup PAC ID 2264403690, 3 clinicians

Practice addresses (Care Compare)

2805 S Horner Blvd
Sanford, NC 27332-8037
Phone (919) 776-1012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Family Eye Center Optometric PA Optometrist Past Accepting new patients
Susan C Whitaker OD PA Optometrist PastSince Apr 1, 1996 Accepting new patients
Martin Eye Associates OD PA Corp Optometrist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1952393035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E MAIN ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273326119",
            "telephone_number": "919-776-1012",
            "fax_number": "919-775-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E MAIN ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273326119",
            "telephone_number": "919-776-1012",
            "fax_number": "919-775-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NATHANIEL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "018AK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.