Individual provider Active NPI

Cydni Noel Martin, PA

  • Physician Assistant
  • Decatur, GA
National Provider Identifier
1144809708
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441
Phone
(404) 537-2521
Fax
(844) 246-7292
NPI assigned
Apr 2, 2021
Reactivated
May 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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 Primary

Addresses

Primary practice location

315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441

Mailing address

4200 River Bottom Dr
Norcross, GA 30092-1300
Phone (404) 626-2593

Other practice location 1

2256 Northlake Pkwy Ste 210
Tucker, GA 30084-4004
Phone (470) 679-2823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230103002014 GA Practitioner - Physician Assistant 8729458054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Morehouse School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ponce Preventive Care LLCGroup PAC ID 6406987544, 10 clinicians

Practice addresses (Care Compare)

315 W Ponce de Leon Ave
Suite 110
Decatur, GA 30030-2441
Phone (404) 537-2521

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Healthcare Providers, LLC PastSince Mar 11, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cydni.martin.1@9773.direct.athenahealth.com

Organizations & group practices 2

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1144809708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 RIVER BOTTOM DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300921300",
            "telephone_number": "404-626-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302441",
            "telephone_number": "404-537-2521",
            "fax_number": "844-246-7292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2256 Northlake Pkwy Ste 210",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300844004",
            "country_code": "US",
            "telephone_number": "470-679-2823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CYDNI",
        "middle_name": "NOEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "deactivation_date": "2025-04-09",
        "reactivation_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.