Individual provider Active NPI

Tanika V. Martin, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1295063329
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004127 Issued in MD
Practice address
9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone
(443) 777-7000
Fax
(443) 777-7123
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0004127 MD Primary

Addresses

Primary practice location

9000 Franklin Square Dr
Baltimore, MD 21237-3901

Mailing address

9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone (443) 777-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, IL2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101119000744 MD Practitioner - Physician Assistant 3678769353 Reassigns benefits to 1 organization
I20220211001459 IL Practitioner - Physician Assistant 3678769353 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois CurrentSince Jun 30, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jun 30, 2022 Accepting new patients
Northwest Hospital Center, Inc CurrentSince Sep 29, 2023 Accepting new patients

Locations

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

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.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1295063329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 FRANKLIN SQUARE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373901",
            "telephone_number": "443-777-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 FRANKLIN SQUARE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373901",
            "telephone_number": "443-777-7000",
            "fax_number": "443-777-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TANIKA",
        "middle_name": "V.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.