NPIMap

Individual provider Active NPI

Mariah J Martin, PA-C

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1124578802
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3011 E Barnett Rd
Medford, OR 97504
Phone
(541) 789-4673
Fax
(541) 789-2121
NPI assigned
Oct 6, 2016
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 NU Primary

Addresses

Primary practice location

3011 E Barnett Rd
Medford, OR 97504

Mailing address

PO Box 4749
Medford, OR 97501
Phone (541) 789-4111

Other practice location 1

510 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 789-4673

Other names 1

  • Mariah J McGaffey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161118001446 OR Practitioner - Physician Assistant 6002195807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
AsanteGroup PAC ID 0547177321, 141 clinicians
Asante Three Rivers Medical Center LLCGroup PAC ID 9931197993, 98 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asante CurrentSince Jan 15, 2022 Accepting new patients
Asante CurrentSince Jan 15, 2022 Accepting new patients
Asante Past Accepting new patients
Asante Three Rivers Medical Center LLC Past Accepting new patients

Locations

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

3011 E Barnett Rd
Medford, OR 97504
Phone (541) 789-4673

Organizations & group practices 5

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 6

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": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1124578802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4749",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-789-4111",
            "fax_number": "541-789-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-789-4673",
            "fax_number": "541-789-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 SW Ramsey Ave",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275554",
            "country_code": "US",
            "telephone_number": "541-789-4673",
            "fax_number": "541-789-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARIAH",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2024-11-04",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "MCGAFFEY",
            "middle_name": "J",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.