Individual provider Active NPI

Michael C. Martin, PA-C

  • Medical Physician Assistant
  • Decatur, GA
National Provider Identifier
1023415528
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7437 Issued in GA
Practice address
315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441
Phone
(404) 537-2521
NPI assigned
Nov 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109166 FL
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X 7437 GA Primary

Addresses

Primary practice location

315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441

Mailing address

315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441
Phone (404) 537-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150324000226 GA Practitioner - Physician Assistant 9739406117 Reassigns benefits to 4 organizations
I20240403003624 TX Practitioner - Physician Assistant 9739406117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ponce Preventive Care LLCGroup PAC ID 6406987544, 10 clinicians

Practice addresses (Care Compare)

315 W Ponce de Leon Ave
Suite 110
Decatur, GA 30030-2441
Phone (404) 537-2521

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109166FLMDMedical Physician Assistant
7437GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9773/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.martin.1@9773.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1023415528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302441",
            "telephone_number": "404-537-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302441",
            "telephone_number": "404-537-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHAEL",
        "middle_name": "C.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-26",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109166",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.