Nicole Martin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7848 Issued in AZ

Practice address

1090 Commerce Dr
Prescott, AZ 86305-3700

Phone

(480) 926-7800

NPI assigned

May 20, 2020

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 AZ

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of YavapaiGroup PAC ID 8921919499, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.martin.p1@direct.canyonlands.nextgenshare.com
• Direct secure messaging: nicole.martinpa.p1@direct.ycchs.nextgenshare.com

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.

• County of Yavapai

  • Public Health or Welfare Agency
  • Prescott, AZ
  • NPI 1659317022
  Medicare reassignment Care Compare group
• Canyonlands Community Health Care

  • Family Medicine Physician
  • Page, AZ
  • NPI 1609966860

  Medical

  Medicare reassignment NPD
• Desert Ridge Medical Group

  • General Practice Physician
  • Phoenix, AZ
  • NPI 1386133080
  Medicare reassignment
• Canyonlands Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Page, AZ
  • NPI 1457187981
  NPD
• County of Yavapai

  • Public Health or Welfare Agency
  • Prescott Valley, AZ
  • NPI 1336265982
  NPD
• County of Yavapai

  • Public Health or Welfare Agency
  • Ash Fork, AZ
  • NPI 1811879455
  NPD
• County of Yavapai

  • Public Health or Welfare Agency
  • Prescott, AZ
  • NPI 1952501389
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1710283593
  NPD (past)

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1114540564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 COMMERCE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 COMMERCE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053700",
            "telephone_number": "480-926-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7848",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7848",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly L Marshall, FNP
• Elaine Ann Martin-Stomel, FNP
• Jeffrey A Martin
• Jennifer L Martin, PMHNP - BC
• Melinda M Martin, M.D.
• Troy John Martin, LMT
• Sierra Martinez
• Brita Martiny-Yssel, PH.D.
• Mary J Huff Psychiatric Nurse Practitioner PLLC
• Renee Elizabeth Mascher, L.C.S.W

• Physician Assistant in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.