Individual provider Active NPI

Erin Tamar Martin, P.A.

  • Surgical Physician Assistant
  • Pontiac, MI
National Provider Identifier
1154449338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601004651 Issued in MI
Practice address
461 W Huron St
Nomc Surgery Department
Pontiac, MI 48341-1601
Phone
(248) 857-7314
Fax
(248) 857-6793
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601004651 MI Primary

Addresses

Primary practice location

461 W Huron St
Nomc Surgery Department
Pontiac, MI 48341-1601

Mailing address

461 W Huron St
Nomc Surgery Department
Pontiac, MI 48341-1601
Phone (248) 857-7314

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
I20070723000186 MI Practitioner - Physician Assistant 7315048204 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren OaklandGroup PAC ID 0547173213, 51 clinicians

Practice addresses (Care Compare)

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5000

Hospital & facility affiliations

  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Oakland Physician Assistant CurrentSince Mar 2, 2019 Accepting new patients
McLaren Oakland Current Accepting new patients
McLaren Oakland CurrentSince Mar 2, 2019 Accepting new patients

Locations

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

5625 Water Tower Pl
Clarkston, MI 48346
Phone (248) 620-4245

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 6

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154449338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "address_2": "NOMC SURGERY DEPARTMENT",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-857-7314",
            "fax_number": "248-857-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "address_2": "NOMC SURGERY DEPARTMENT",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-857-7314",
            "fax_number": "248-857-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ERIN",
        "middle_name": "TAMAR",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601004651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.