Teresa D Martin, PA-C

Key facts

NPI

1104890672

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

PA12432 (TX)

Practice address

1855 Gattis School Rd
Round Rock, TX 78664-7428

Phone

(512) 238-6268

NPI assigned

Feb 14, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 10

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.

• Benefis Hospitals Inc Multi-Specialty Clinic/Center · Great Falls, MT · NPI 1780968974
  Medicare reassignment NPD MT
• Cherokee Nation Multi-Specialty Clinic/Center · Sallisaw, OK · NPI 1780692723
  Medicare reassignment NPD TX
• MC Medical Group of Nevada, P.C Family Nurse Practitioner · Las Vegas, NV · NPI 1730266537
  Medicare reassignment NV
• Open Door Community Health Centers Federally Qualified Health Center (FQHC) · Crescent City, CA · NPI 1497840656
  Medicare reassignment CA
• Gupta, D.O. & Associates, LLC Urgent Care Clinic/Center · Weatherford, TX · NPI 1093815078
  Care Compare group
• Cherokee Nation Public Health or Welfare Agency · Tahlequah, OK · NPI 1013884154
  NPD
• Cherokee Nation Multi-Specialty Clinic/Center · Claremore, OK · NPI 1497568968
  NPD
• Cherokee Nation Multi-Specialty Clinic/Center · Muskogee, OK · NPI 1841207156
  NPD
• Open Door Community Health Centers Federally Qualified Health Center (FQHC) · Eureka, CA · NPI 1669569109
  NPD
• Open Door Community Health Centers Federally Qualified Health Center (FQHC) · Eureka, CA · NPI 1831713452
  NPD

Medicare Care Compare profile

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gupta DO and Associates LLC (8 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled (4 enrollments) in CA, NV, TX, MT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: teresa.martin.p1@direct.cmcentersinc.nextgenshare.com
• Direct secure messaging: teresa.martin.1@6815.direct.athenahealth.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 20, 2022.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1104890672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 HIGHKNOLL LANE",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281015",
            "telephone_number": "904-468-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 GATTIS SCHOOL RD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647428",
            "telephone_number": "512-238-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TERESA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22297",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1792",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "35362",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA12432",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

• Dianna C Martin, PHYSICIAN ASSISTANT
• Douglas Martin, MD
• Hannah Louise Martin, PT, DPT
• Lynne K Martin, O.D.
• Michael Dean Martin, MD
• Aliyah Giselle Martinez
• Destiny Lyssette Martinez, RBT
• Katherine Martinez, BA
• Merisa Martinez, MS, RDN
• Natalia Louise Martinez

All providers in Round Rock, TX · Physician Assistant in Texas