Individual provider Active NPI

Christopher William Martella, DO

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1962479063
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43310 Issued in CO
Practice address
3519 Richmond Dr
Fort Collins, CO 80526-5995
Phone
(970) 204-0300
Fax
(970) 226-9041
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43310 CO
Emergency Medicine Physician 207P00000X A-1353-06 NM
Family Medicine Physician 207Q00000X 43310 CO Primary

Addresses

Primary practice location

3519 Richmond Dr
Fort Collins, CO 80526-5995

Mailing address

3702 Automation Way
Suite 103
Fort Collins, CO 80525-5737
Phone (970) 224-1670

Other identifiers 2

IdentifierTypeStateIssuer
66756332MedicaidNM
36372048MedicaidCO

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
43310COMDEmergency Medicine Physician
A-1353-06NMMDEmergency Medicine Physician
43059COMDHospice and Palliative Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Emergency Med Associates LLC Emergency Medicine Past Accepting new patients
Bayfront Emergency Physicians PA Emergency Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1962479063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY",
            "address_2": "SUITE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255737",
            "telephone_number": "970-224-1670",
            "fax_number": "970-495-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 RICHMOND DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265995",
            "telephone_number": "970-204-0300",
            "fax_number": "970-226-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELLA",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "43310",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "A-1353-06",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "43310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66756332",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36372048",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.