Kayleigh Martincic, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP026479 Issued in PA

Practice address

128 Lakeside Ave
Burlington, VT 05401-4939

Phone

(802) 657-7000

NPI assigned

Oct 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1023735677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE STE 260",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939",
            "telephone_number": "802-657-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINCIC",
        "first_name": "KAYLEIGH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rick Martelli
• Jacob Anthony Martin, M.D.
• Karlyn Anne Martin, M.D.
• Lynn Ruth Martin, LCMHC
• Natalie Sarah Martin
• Karla Martinez-Dulmer, MD
• Martins Foods of South Burlington LLC
• Lisa Martiny, LICSW
• Samuel Mashiah
• Larissa Masnyk, DO

• Family Nurse Practitioner in Burlington, VT
• Providers in Burlington, VT by specialty
• Family Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.

Verify at the official NPI Registry.