Individual provider Active NPI

Leah Kathryn Martin, PA-C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1063930550
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008358 Issued in MI
Practice address
1277 Mercy Dr
Muskegon, MI 49444-4605
Phone
(231) 672-6186
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 5601008358 MI Primary

Addresses

Primary practice location

1277 Mercy Dr
Muskegon, MI 49444-4605

Mailing address

1277 Mercy Dr
Muskegon, MI 49444-4605
Phone (231) 672-6187

Other names 1

  • Leah Kathryn Farina Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmartin151815@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20171003005282 MI Practitioner - Physician Assistant 4981979887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Partners Sub-Specialty ServicesGroup PAC ID 3274504105, 33 clinicians

Practice addresses (Care Compare)

1277 Mercy Dr
Muskegon, MI 49444-4605
Phone 23167261862

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Oct 2, 2017 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 2, 2017 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

25 Michigan St NE
Ste 6100
Grand Rapids, MI 49503
Phone (616) 267-7900

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: lmartin151815@direct.trinity-health.org

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 and National Provider Directory roles.

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": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1063930550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494444605",
            "telephone_number": "231-672-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494444605",
            "telephone_number": "231-672-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LEAH",
        "middle_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmartin151815@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Muskegon Sleep Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1277 Mercy Dr",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494444605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "FARINA",
            "middle_name": "KATHRYN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.