Individual provider Active NPI

Melissa Kathleen Martin, MD

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1962430090
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
058071 Issued in GA
Practice address
1500 Oglethorpe Ave
Suite 2500
Athens, GA 30606-2179
Phone
(706) 548-7909
Fax
(706) 543-6091
NPI assigned
Jun 29, 2006
Last updated
Jun 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 058071 GA Primary
Pediatrics Physician 208000000X 058071 GA

Addresses

Primary practice location

1500 Oglethorpe Ave
Suite 2500
Athens, GA 30606-2179

Mailing address

1500 Oglethorpe Ave
Suite 2500
Athens, GA 30606-2179
Phone (706) 548-7909

Other identifiers 2

IdentifierTypeStateIssuer
747573398AMedicaidGA
747573398BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20060829000107 GA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4688678980 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Maryland School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians
Piedmont Athens Primary Care LLCGroup PAC ID 0648520841, 80 clinicians

Practice addresses (Care Compare)

1010 Village Dr
Watkinsville, GA 30677-6004
Phone (706) 534-6970

1305 Jennings Mill Rd
Suite 120
Watkinsville, GA 30677-7241
Phone (706) 410-2005

1500 Oglethorpe Ave
Suite 600B
Athens, GA 30606-2185
Phone (706) 549-3426

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
058071GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Jul 5, 2023 Accepting new patients
Piedmont Athens Primary Care LLC CurrentSince Jul 1, 2018 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC Internal Medicine CurrentSince Apr 15, 2022 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients
Athens Regional Physician Services Internal Medicine Past Accepting new patients
Athens Regional Physicians Services Pediatrics PastSince Jul 1, 2018 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1500 Oglethorpe Ave
Ste 2200
Athens, GA 30606
Phone (706) 543-0471

1500 Oglethorpe Ave
Ste 2500
Athens, GA 30606
Phone (706) 543-0471

1500 Oglethorpe Ave
Ste 600B
Athens, GA 30606
Phone (706) 549-3426

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1962430090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 2500",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-548-7909",
            "fax_number": "706-543-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 2500",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-548-7909",
            "fax_number": "706-543-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELISSA",
        "middle_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "058071",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "058071",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747573398A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747573398B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.