Individual provider Active NPI

Martin J Kerzer, DO

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1962495416
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO00303 Issued in RI
Practice address
857 Post Rd
Warwick, RI 02888-3360
Phone
(401) 467-3115
Fax
(401) 785-8468
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO00303 RI Primary

Addresses

Primary practice location

857 Post Rd
Warwick, RI 02888-3360

Mailing address

857 Post Rd
Warwick, RI 02888-3360
Phone (401) 467-3115

Other identifiers 1

IdentifierTypeStateIssuer
9003198MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20100826001116 RI Practitioner - Family Practice 6800813270 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO00303RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Physicians, LLC Family Medicine CurrentSince Apr 6, 2020 Accepting new patients

Locations

1681 Cranston St
Cranston, RI 02920
Phone (401) 944-6889

1 Office Pkwy
East Providence, RI 02914
Phone (401) 270-7110

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

857 Post Rd
Warwick, RI 02888
Phone (401) 467-3115

Organizations & group practices 1

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1962495416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883360",
            "telephone_number": "401-467-3115",
            "fax_number": "401-785-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883360",
            "telephone_number": "401-467-3115",
            "fax_number": "401-785-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERZER",
        "first_name": "MARTIN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9003198",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.