David E Martin, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA39 Issued in ID

Practice address

845 W Center St
Suite 200
Pocatello, ID 83204-4205

Phone

(208) 232-6260

Fax

(208) 232-6259

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Practice Group, P.a.Group PAC ID 1658275391, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Family Practice Group, P.a.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1205869310

  ID

  Medicare reassignment Care Compare group
• Family Practice Group, P.a.

  • Cardiac Rehabilitation Clinic/Center
  • Pocatello, ID
  • NPI 1912723214
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1740143882
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215929690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2377",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062377",
            "telephone_number": "208-232-7862",
            "fax_number": "208-232-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 W CENTER ST",
            "address_2": "SUITE 200",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044205",
            "telephone_number": "208-232-6260",
            "fax_number": "208-232-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA39",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021913",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSI - POKY",
            "identifier": "000010151329",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCI - POKY",
            "identifier": "PANR7",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Aaron Marler, CRNA
• Tyler Kent Marlowe, DDS
• Jordon Marshall, D.O.
• Robert Ammon Marshall
• Robert Lance Marshall, PT, DPT, MS
• Laynie Martin, LMSW
• Melanie Katharine Martin, TSLP
• Morningstar Martin
• Anthony Martinez
• Isabela Mary Martinez

• Medical Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.