NPIMap

Individual provider Active NPI

Tara Dawn Martinez, DO

  • Colon & Rectal Surgery Physician
  • Commack, NY
National Provider Identifier
1962693887
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
267602 Issued in NY
Practice address
2171 Jericho Tpke Ste 100
Commack, NY 11725-2900
Phone
(631) 486-5030
Fax
(631) 486-2694
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 267602 NY
Colon & Rectal Surgery Physician 208C00000X OS16564 FL
Colon & Rectal Surgery Physician 208C00000X 267602 NY Primary

Addresses

Primary practice location

2171 Jericho Tpke Ste 100
Commack, NY 11725-2900

Mailing address

2171 Jericho Tpke Ste 100
Commack, NY 11725-2900
Phone (631) 486-5030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130625000019 NY Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 3274772272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

Hospital & facility affiliations

  • NYU Langone Home Health Care Home health agency, Garden City, NY, CCN 337187
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy26

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 1, 2023 Accepting new patients
New York University Surgery CurrentSince Apr 1, 2023 Accepting new patients
Manhattan Medical Practice PC CurrentSince Apr 4, 2023 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

185 Central Ave
Bethpage, NY 11714
Phone (516) 733-7100

2171 Jericho Tpke
Ste 100
Commack, NY 11725
Phone (631) 343-7242

167 Veterans Memorial Hwy
Commack, NY 11725
Phone (631) 909-6262

180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

989 W Jericho Tpke
Ste 1
Smithtown, NY 11787
Phone (631) 486-5030

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: tmartinez548706@nyumc.direct-ci.com
  • Direct secure messaging: tara.martinez@hca4.eclinicaldirectplus.com

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.

Hospital & facility affiliations 10

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1962693887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 JERICHO TPKE STE 100",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252900",
            "telephone_number": "631-486-5030",
            "fax_number": "631-724-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 JERICHO TPKE STE 100",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252900",
            "telephone_number": "631-486-5030",
            "fax_number": "631-486-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TARA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2022-04-21",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "267602",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "OS16564",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "267602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.