Individual provider Active NPI

Michelle Martin

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1063823383
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09277 Issued in TX
Practice address
4107 Medical Pkwy Ste 210
Austin, TX 78756-3738
Phone
(512) 323-5465
Fax
(512) 327-1390
NPI assigned
May 9, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09277 TX Primary

Addresses

Primary practice location

4107 Medical Pkwy Ste 210
Austin, TX 78756-3738

Mailing address

4107 Medical Pkwy Ste 210
Austin, TX 78756-3738
Phone (512) 323-5465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20150130000262 TX Practitioner - Physician Assistant 1850615477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1400 N Ih 35
Austin, TX 78701-1926

1400 N Ih 35 LL
Cl400 Tri County Prac Assoc
Austin, TX 78701-1926
Phone (512) 324-7300

201 Seton Pkwy
Round Rock, TX 78665-8000
Phone (512) 324-4000

6001 Kyle Pkwy
Kyle, TX 78640-6112
Phone (512) 504-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Jan 6, 2020 Accepting new patients
Seton Family of Doctors CurrentSince Jan 6, 2020 Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

4616 W Howard Ln
Austin, TX 78728
Phone (224) 558-8613

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063823383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 MEDICAL PKWY STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563738",
            "telephone_number": "512-323-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 MEDICAL PKWY STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563738",
            "telephone_number": "512-323-5465",
            "fax_number": "512-327-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.