Individual provider Active NPI

Mars Surbano Martinez, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1982613030
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13951 Issued in OK
Practice address
7109 W Hefner Rd
Suite D
Oklahoma City, OK 73162-4534
Phone
(405) 722-5500
Fax
(405) 720-4404
NPI assigned
Aug 7, 2006
Last updated
Jun 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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 13951 OK Primary

Addresses

Primary practice location

7109 W Hefner Rd
Suite D
Oklahoma City, OK 73162-4534

Mailing address

7109 W Hefner Rd
Suite D
Oklahoma City, OK 73162-4535
Phone (405) 722-5500

Other identifiers 2

IdentifierTypeStateIssuer
100253420BMedicaidOK
400522462OtherOKMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20041207001062 OK Practitioner - Emergency MedicinePractitioner - Family Practice 8224094602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10912 N Council Rd
Oklahoma City, OK 73162-2504
Phone (405) 722-5500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norstar Emergency Physicians Past Accepting new patients
Summit Medical Center Past Accepting new patients
Am PM Doctors Occupational Pain Center PastSince Mar 9, 2005 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1982613030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 W HEFNER RD",
            "address_2": "SUITE D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731624535",
            "telephone_number": "405-722-5500",
            "fax_number": "405-720-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 W HEFNER RD",
            "address_2": "SUITE D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731624534",
            "telephone_number": "405-722-5500",
            "fax_number": "405-720-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARS",
        "middle_name": "SURBANO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "13951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253420B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "400522462",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.