Active NPI
Craig P. Martin, PA-C
- Surgical Physician Assistant
- Issaquah, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA61519926
- Practice address
- 510 8TH Ave NE Ste 200
Issaquah, WA 98029-5436 - Phone
- (425) 392-3030
- Fax
- (425) 392-2564
- NPI assigned
- Jan 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA61519926 | WA | Primary |
Addresses
Primary practice location
510 8TH Ave NE Ste 200
Issaquah, WA 98029-5436
Mailing address
510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 507-0733
Other practice location 1
3101 Northup Way Ste 201
Bellevue, WA 98004-1435
Phone (425) 455-3600
Other practice location 2
515 Minor Ave Ste 200
Seattle, WA 98104-2133
Phone (425) 455-3600
Other practice location 3
18100 NE Union Hill Rd Ste 330
Redmond, WA 98052-3330
Phone (425) 455-3600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210122000667 | NY | Practitioner - Physician Assistant | 2264846898 | Reassigns benefits to 1 organization |
| I20240604000889 | WA | Practitioner - Physician Assistant | 2264846898 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proliance Surgeons Inc P S
Practice addresses (Care Compare)
3101 Northup Way
Bellevue, WA 98004-1449
510 8TH Ave NE
Issaquah, WA 98029-5436
515 Minor Ave
Suite 200
Seattle, WA 98104-2133
Phone (425) 656-5060
751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 313-5422
Hospital & facility affiliations
- Overlake Hospital Medical Center & Clinics
- Swedish Issaquah
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA61519926 | WA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Surgical | Current | Accepting new patients |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Proliance Surgeons, Inc., P.S. | Current | Accepting new patients |
Locations
178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456
1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480
3101 Northup Way
Ste 201
Bellevue, WA 98004
Phone (425) 455-3600
510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030
18100 NE Union Hill Rd
Ste 330
Redmond, WA 98052
Phone (425) 392-3030
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615
Interoperability endpoints
- cmartin346983@bassett.direct-ci.net
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 and National Provider Directory roles.
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- Specialty Pharmacy
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- NPI 1174419196
Hospital & facility affiliations 3
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": "1547251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716249600000",
"number": "1154895175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 8TH AVE NE STE 320",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980295436",
"telephone_number": "425-507-0733",
"fax_number": "425-283-5551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 8TH AVE NE STE 200",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980295436",
"telephone_number": "425-392-3030",
"fax_number": "425-392-2564"
}
],
"practiceLocations": [
{
"address_1": "3101 Northup Way Ste 201",
"address_purpose": "LOCATION",
"city": "Bellevue",
"state": "WA",
"postal_code": "980041435",
"country_code": "US",
"telephone_number": "425-455-3600",
"fax_number": "425-455-3920",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "515 Minor Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981042133",
"country_code": "US",
"telephone_number": "425-455-3600",
"fax_number": "425-455-3920",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "18100 NE Union Hill Rd Ste 330",
"address_purpose": "LOCATION",
"city": "Redmond",
"state": "WA",
"postal_code": "980523330",
"country_code": "US",
"telephone_number": "425-455-3600",
"fax_number": "425-455-3920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "CRAIG",
"middle_name": "P.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-12",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WA",
"license": "PA61519926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.