Peter J Martin

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

025211PA10000093 Issued in WA

Practice address

N. 115 Crosby
Tekoa, WA 99033-0629

Phone

(509) 284-2423

Fax

(509) 284-3434

NPI assigned

Mar 12, 2007

Last updated

Nov 4, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peter J Martin

  dba Tekoa Rural Health Clinic

  • Rural Health Clinic/Center
  • Tekoa, WA
  • NPI 1366768046

  Medical

  NPD (past) Authorized official
• Peter J. Martin

  dba Tekoa Medical Clinic

  • Family Medicine Physician
  • Tekoa, WA
  • NPI 1285766469
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1194857532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "TEKOA",
            "state": "WA",
            "postal_code": "990330629",
            "telephone_number": "509-284-2423",
            "fax_number": "509-284-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N. 115 CROSBY",
            "city": "TEKOA",
            "state": "WA",
            "postal_code": "990330629",
            "telephone_number": "509-284-2423",
            "fax_number": "509-284-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PETER",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "025211PA10000093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8349276",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Diane Blaszak, LMHC
• Melissa Anne Osborne
• Peter J Martin (Tekoa Rural Health Clinic)
• Peter J. Martin (Tekoa Medical Clinic)
• Patricia L Primmer
• Tekoa Community Ambulance

• Medical Physician Assistant in Tekoa, WA
• Providers in Tekoa, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.