MR. JOHN PAUL MARTIN MD
NPI 1902804537
Family Medicine in Oneida, TN
NPI Status: Active since July 08, 2005
Contact Information
189 ANDREW ST
ONEIDA, TN
ZIP 37841
Phone: (423) 569-3762
Fax: (423) 569-4909
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About JOHN MARTIN
This page provides the complete NPI Profile along with additional information for John Martin, a primary care provider established in Oneida, Tennessee with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1902804537 assigned on July 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 26733 (TN). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1902804537
- Provider Name
- MR. JOHN PAUL MARTIN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 189 ANDREW ST ONEIDA, TN 37841
- Location Phone
- (423) 569-3762
- Location Fax
- (423) 569-4909
- Mailing Address
- PO BOX 4908 ONEIDA, TN 37841
- Mailing Phone
- (423) 569-3762
- Mailing Fax
- (423) 569-4909
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-08-2005
- Last Update Date
- 09-02-2016
- Code Navigator
A primary care provider (PCP) like John Martin sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 26733
- License State
- TN
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 26733 (TN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B07S HSA - EPO
- BlueCross B15S $0 virtual care from Teladoc Health � - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental - EPO
- BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental - EPO
- Connect Bronze 3500 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Bronze 7500 Indiv Med Deductible - EPO
- Connect Bronze 8500 Indiv Med Deductible - EPO
- Connect Bronze CMS Standard - EPO
- Connect Gold CMS Standard - EPO
- Connect Silver 2500 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Silver 2875 Indiv Med Deductible - EPO
- Connect Silver 3825 Indiv Med Deductible - EPO
- Connect Silver CMS Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
64713324 | MEDICAID (05) | KY | |
3094640 | MEDICAID (05) | TN | |
E40998 | MEDICARE UPIN (02) | ||
3094646 | MEDICARE PIN (08) |
Medicare Participation & PECOS Enrollment Status
John Martin is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Unknown
Other-Enteral and Parenteral (OB006N)
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)
1 DME suppliers used 11 Medicare Claims 341 Services Paid
Durable Medical Equipment
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
4 DME suppliers used 23 Medicare Claims 28 Services Paid
DME-Other DME (DE000N)
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Iv pole (HCPCS:E0776)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar (HCPCS:E0910)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE000N)
Transport chair, adult size, patient weight capacity up to and including 300 pounds (HCPCS:E1038)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 30 Medicare Claims 32 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 37841 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.53
- Minimum New Patient Price $52.64
- Maximum New Patient Price $160.89
- Average New Patient Copayment $20.38
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.6
- Minimum Established Patient Price $16.72
- Maximum Established Patient Price $131.41
- Average Established Patient Copayment $23.4
- Minimum Established Patient Copayment $4.18
- Maximum Established Patient Copayment $32.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 9 | 0 | 2 | 8 | 0 | 4 | 5 | 3 | 7 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 9 | 0 | 2 | 16 | 0 | 8 | 5 | 6 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 9 + 0 + 2 + 1 + 6 + 0 + 8 + 5 + 6 + 24 = 63 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 63 = 7 | 7 |
The NPI number 1902804537 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
MRS. AIMEE NICOLE MARLAR APRN
Nurse Practitioner
(Primary Care)
189 ANDREW ST
ONEIDA, TN
ZIP 37841
ELIZABETH BIERI CNM, IBCLC
Advanced Practice Midwife
189 ANDREW ST
ONEIDA, TN
ZIP 37841
DR. PETER MICHAEL LITCHFIELD MD
General Practice
189 ANDREW ST
ONEIDA, TN
ZIP 37841
CIRCLE OF LIFE OBSTETRICS AND FAMILY CARE, PLLC
Clinic/Center
(Rural Health)
189 ANDREW ST
ONEIDA, TN
ZIP 37841
CIRCLE OF LIFE OBSTETRICS AND PRIMARY CARE, PLLC
Clinic/Center
(Primary Care)
189 ANDREW ST
ONEIDA, TN
ZIP 37841
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902804537, enumerated as an "individual" on July 08, 2005.
The provider is located at 189 ANDREW ST ONEIDA, TN 37841 and the phone number is (423) 569-3762.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Cigna. Please consult your insurance carrier or call the provider to verify.