Individual provider Active NPI

David Zachary Martin, M.D.

  • Plastic Surgery Physician
  • Baltimore, MD
National Provider Identifier
1972585206
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D0058474 Issued in MD
Practice address
5601 Loch Raven Blvd BLDG Suite101
Baltimore, MD 21239-2945
Phone
(443) 444-1392
Fax
(443) 444-3988
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X D0058474 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd BLDG Suite101
Baltimore, MD 21239-2945

Mailing address

5601 Loch Raven Blvd BLDG Suite101
Baltimore, MD 21239-2945
Phone (443) 444-1392

Other identifiers 11

IdentifierTypeStateIssuer
7283425OtherMDAETNA ALL PLANS EXCEPT HMO
405073800MedicaidMD
1972585206OtherMDBRAVO
P01084428OtherMDRAILROAD MEDICARE
107110OtherMDJOHN HOPKINS EHP PPMCO USFHP
01642018OtherMDAMERIGROUP
1188979OtherMDCIGNA
AB870001OtherMDCAREFIRST BLUECROSS BLUESHIELD
1972585206OtherMDMARYLAND PHYSICIANS CARE
1972585206OtherMDUNITED HEALTHCARE - ALL PRODUCTS EXCEPT AMERICHOICE
8508989OtherMDAETNA HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20040720000228 MD Practitioner - Plastic and Reconstructive Surgery 4981683109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
George Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-2626

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision35
Removal of tissue2050
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0058474MDMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

5601 Loch Raven Blvd
Ofc
Baltimore, MD 21239
Phone (410) 433-4300

5601 Loch Raven Blvd
#B
Baltimore, MD 21239
Phone (443) 687-9990

5601 Loch Raven Blvd
Ste 200
Baltimore, MD 21239
Phone (443) 444-4288

5601 Loch Raven Blvd
Bldg 101
Baltimore, MD 21239
Phone (410) 433-4300

5601 Loch Raven Blvd
Ste 101
Baltimore, MD 21239
Phone (410) 433-4300

5601 Loch Raven Blvd
Ste 206
Baltimore, MD 21239
Phone (410) 464-5600

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

7501 Greenway Center Dr
Ste 220
Greenbelt, MD 20770
Phone (240) 965-7358

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medstar Union Memorial HospitalBaltimore, MD, CCN 210024 Hospital Corporate Director Nov 1, 2018
Medstar Good Samaritan HospitalBaltimore, MD, CCN 210056 Hospital Corporate Director Nov 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 4

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1972585206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD BLDG SUITE101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-1392",
            "fax_number": "443-444-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD BLDG SUITE101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-1392",
            "fax_number": "443-444-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0058474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ALL PLANS EXCEPT HMO",
            "identifier": "7283425",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405073800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO",
            "identifier": "1972585206",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01084428",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS EHP PPMCO USFHP",
            "identifier": "107110",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01642018",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1188979",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECROSS BLUESHIELD",
            "identifier": "AB870001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND PHYSICIANS CARE",
            "identifier": "1972585206",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE - ALL PRODUCTS EXCEPT AMERICHOICE",
            "identifier": "1972585206",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "8508989",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.