Jessamine Martin, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS018877 Issued in PA

Practice address

2595 Interstate Dr Ste 103
Harrisburg, PA 17110-9378

Phone

(800) 370-3651

NPI assigned

May 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vital Healthcare SolutionsGroup PAC ID 3274830336, 107 clinicians

Silver Willow Wellness PCGroup PAC ID 5597271577, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Silver Willow Wellness PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Reading, PA
  • NPI 1659164697
  Medicare reassignment Care Compare group NPD
• Vital Healthcare Solutions

  • Psychiatry Physician
  • Sinking Springs, PA
  • NPI 1659736957
  Medicare reassignment Care Compare group NPD
• Center for Integrated Behavioral Health,LLC

  • Psychologist
  • Bethlehem, PA
  • NPI 1083981104
  Medicare reassignment NPD
• Che Senior Care Therapy Services PC

  • Clinical Psychologist
  • King of Prussia, PA
  • NPI 1144666496
  Medicare reassignment NPD

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1033567599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 BOSTON POST RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751750",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 INTERSTATE DR STE 103",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109378",
            "telephone_number": "800-370-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 East Broad Street, Suite 510",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "18018",
            "country_code": "US",
            "telephone_number": "610-865-4300",
            "fax_number": "402-483-7045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSAMINE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018877",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sue Marsico, M.S., LPC
• Daniel McInerney Martin, LSW
• Ed Martin
• Enos Daniel Martin, M.D.
• Jack T. Martin, MD
• Jessica Martin, MSW, LSW
• Karen S Martin, RN, CRNI
• Kellie Martin
• Lisa Ann Martin, LCSW
• Maria Martin, MS, LBS

• Clinical Psychologist in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.