Active NPI
Serge Anthony Martinez, MD
- Otolaryngology Physician
- Louisville, KY
National Provider Identifier
1962472969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 21314
- Practice address
- 4950 Norton Healthcare Blvd
Suite 209
Louisville, KY 40241-2845 - Phone
- (502) 425-5556
- Fax
- (502) 992-0079
- NPI assigned
- Jan 24, 2006
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 21314 | KY | Primary |
Addresses
Primary practice location
4950 Norton Healthcare Blvd
Suite 209
Louisville, KY 40241-2845
Mailing address
4950 Norton Healthcare Blvd
Suite 209
Louisville, KY 40241-2845
Phone (502) 425-5556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64218143 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21314 | KY | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Ear Nose Throat & Allergy,PLLC | Otolaryngology | Past | Accepting new patients |
| University Physicians Group - Radiology | Past | Accepting new patients | |
| Ear, Nose & Throat Surgeons of Western New England, LLC | Otolaryngology | Past | Accepting new patients |
| University Surgical Associates, PSC | Otolaryngology | 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.
-
- Otolaryngology Physician
- Louisville, KY
- NPI 1588604896
-
- Diagnostic Radiology Physician
- Louisville, KY
- NPI 1619061116
-
- Otolaryngology Physician
- Springfield, MA
- NPI 1386685881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203638400000",
"number": "1962472969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4950 NORTON HEALTHCARE BLVD",
"address_2": "SUITE 209",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402412845",
"telephone_number": "502-425-5556",
"fax_number": "502-992-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4950 NORTON HEALTHCARE BLVD",
"address_2": "SUITE 209",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402412845",
"telephone_number": "502-425-5556",
"fax_number": "502-992-0079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "SERGE",
"middle_name": "ANTHONY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2008-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "KY",
"license": "21314",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64218143",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.