Individual provider Active NPI

David C Martin, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1336255504
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003270 Issued in MI
Practice address
5333 McAuley Dr
Suite 6016
Ypsilanti, MI 48197-1005
Phone
(734) 712-8350
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 003270 MI
Physician Assistant 363A00000X 5601003270 MI Primary

Addresses

Primary practice location

5333 McAuley Dr
Suite 6016
Ypsilanti, MI 48197-1005

Mailing address

PO Box 932701
Cleveland, OH 44193-0015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050824000434 MI Practitioner - Physician Assistant 0840221404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huron Valley Radiology PCGroup PAC ID 2961466859, 76 clinicians

Practice addresses (Care Compare)

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-3000

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

5303 Elliott Dr
Suite 2661
Ypsilanti, MI 48197-8632
Phone (734) 712-0280

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003270MIMDDiagnostic Radiology Physician
5601003270MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Consultants Inc Diagnostic Radiology CurrentSince Apr 1, 2024 Accepting new patients
Beaumont Special Radiological Procedures Diagnostic Radiology Past Accepting new patients

Locations

7575 Grand River Rd
Ste 103
Brighton, MI 48114
Phone (866) 522-8268

5333 McAuley Dr
Rm 6016
Ypsilanti, MI 48197

Organizations & group practices 3

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620432000000",
    "number": "1336255504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932701",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "SUITE 6016",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971005",
            "telephone_number": "734-712-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "003270",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.