Individual provider Active NPI

Tiffany T Martin

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1184597189
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
83 Ernest Barrett Pkwy Unit 1201
Marietta, GA 30066-3494
Phone
(678) 977-7484
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 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

83 Ernest Barrett Pkwy Unit 1201
Marietta, GA 30066-3494

Mailing address

83 Ernest Barrett Pkwy Unit 1201
Marietta, GA 30066-3494
Phone (678) 977-7484

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
I20260317003850 GA Practitioner - Physician Assistant 7315421443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2500 Hospital Blvd
Suite 310
Roswell, GA 30076-4947
Phone (770) 664-9600

Hospital & facility affiliations

  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1184597189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 ERNEST BARRETT PKWY UNIT 1201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663494",
            "telephone_number": "678-977-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 ERNEST BARRETT PKWY UNIT 1201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663494",
            "telephone_number": "678-977-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TIFFANY",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.