Active NPI
Shemika Amanda Martin, MD
- Family Medicine Physician
- Paramus, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MA12096700
- Practice address
- 30 W Century Rd Ste 210
Paramus, NJ 07652-1440 - Phone
- (201) 632-5057
- Fax
- (201) 483-9201
- NPI assigned
- Mar 30, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA12096700 | NJ | Primary |
Addresses
Primary practice location
30 W Century Rd Ste 210
Paramus, NJ 07652-1440
Mailing address
3 University PLZ Ste 205
Hackensack, NJ 07601-6208
Phone (201) 833-3599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- 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
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 W Century Rd
Suite 210
Paramus, NJ 07652-1440
Phone (201) 632-5057
Hospital & facility affiliations
- Holy Name Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA12096700 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holy Name Health Physicians | Family Medicine | Current | Accepting new patients |
| Excelcare Medical Associates, PA | Family Medicine | Current | Accepting new patients |
Locations
3 University Plz
Ste 205
Hackensack, NJ 07601
30 W Century Rd
Paramus, NJ 07652
Phone (201) 261-2000
30 W Century Rd
Ste 210
Paramus, NJ 07652
Phone (201) 261-0170
1 W Ridgewood Ave
Ste 203
Paramus, NJ 07652
Phone (201) 312-5243
718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232
222 Cedar Ln
Ste 109
Teaneck, NJ 07666
Phone (201) 379-5650
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.
-
- Internal Medicine Physician
- Teaneck, NJ
- NPI 1992736300
Family Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Teaneck, NJ
- NPI 1043389349
Hospital
-
- General Acute Care Hospital
- Teaneck, NJ
- NPI 1104859131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1952989113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 UNIVERSITY PLZ STE 205",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076016208",
"telephone_number": "201-833-3599",
"fax_number": "201-227-6207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W CENTURY RD STE 210",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076521440",
"telephone_number": "201-632-5057",
"fax_number": "201-483-9201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SHEMIKA",
"middle_name": "AMANDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-30",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MA12096700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.