Individual provider Active NPI

Edward T Martin, M.D.

  • Cardiovascular Disease Physician
  • Tulsa, OK
National Provider Identifier
1982674719
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
20675 Issued in OK
Practice address
9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718
Phone
(918) 592-0999
Fax
(918) 878-2499
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20675 OK
Cardiovascular Disease Physician 207RC0000X 20675 OK Primary

Addresses

Primary practice location

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718

Mailing address

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718
Phone (918) 592-0999

Other identifiers 4

IdentifierTypeStateIssuer
100028120AMedicaidOK
060049596OtherOKMEDICARE RAILROAD
OK700124OtherOKMEDICARE PTAN
P00613404OtherOKMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080716000260 OK Practitioner - Cardiovascular Disease (Cardiology) 8224931241 Reassigns benefits to 2 organizations
I20230515001892 TX Practitioner - Cardiovascular Disease (Cardiology) 8224931241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5722
Phone (918) 592-0999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20675OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Heart LLC Specialist CurrentSince Apr 16, 2008 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Apr 4, 2023 Accepting new patients
Creek Nation Hospital & Clinics Specialist CurrentSince Apr 4, 2023 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Apr 4, 2023 Accepting new patients
Oklahoma Heart Inc Specialist Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients
Integris Cardiovascular Physicians LLC Cardiovascular Disease Past Accepting new patients

Locations

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

Dept 1218
Tulsa, OK 74182

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 579-2981

Dept 1467
Tulsa, OK 74182

Dept 1038
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Interoperability endpoints

  • Direct secure messaging: emartin106867@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1982674719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-592-0999",
            "fax_number": "918-878-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-592-0999",
            "fax_number": "918-878-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EDWARD",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "20675",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "20675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100028120A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060049596",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "OK700124",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00613404",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.