Individual provider Active NPI

Craig P. Martin, PA-C

  • Surgical Physician Assistant
  • Issaquah, WA
National Provider Identifier
1154895175
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61519926 Issued in WA
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

Updated by the provider on May 21, 2024

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 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, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
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 SGroup PAC ID 8527972900, 395 clinicians

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 Hospital, Bellevue, WA, CCN 500051
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61519926WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jan 11, 2021 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince May 20, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 11, 2021 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince May 20, 2024 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.