Active NPI
Barbara Elizabeth Martin, PA
- Physician Assistant
- Portland, OR
National Provider Identifier
1003864166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA01041
- Practice address
- 727 W Burnisde
Portland, OR 97209 - Phone
- (503) 228-4533
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA01041 | OR | Primary |
Addresses
Primary practice location
727 W Burnisde
Portland, OR 97209
Mailing address
232 NW 6TH Ave
Portland, OR 97209-3609
Phone (503) 228-4533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121115000237 | OR | Order and Referring Only - Physician Assistant | 9133141849 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA01041 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central City Concern, Inc | Past | Accepting new patients | |
| Central City Concern | Past | Accepting new patients | |
| Central City Concern | Past | Accepting new patients |
Networks
- WA PPO C-SNP
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
Interoperability endpoints
- bmartin665415@direct.ochin.org
Organizations & group practices 3
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.
-
- Substance Abuse Rehabilitation Facility
- Portland, OR
- NPI 1679832315
-
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1881658276
-
- Federally Qualified Health Center (FQHC)
- Portland, OR
- NPI 1548071848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411516800000",
"number": "1003864166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 NW 6TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093609",
"telephone_number": "503-228-4533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 W BURNISDE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97209",
"telephone_number": "503-228-4533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "BARBARA",
"middle_name": "ELIZABETH",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2014-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA01041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.