Kaitlyn Taylor Martino, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3879 Issued in SC

Practice address

920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181

Phone

(843) 497-6348

Fax

(843) 497-6351

NPI assigned

Jan 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, GU2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Strand Surgical Specialists LLCGroup PAC ID 4082770656, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kaitlyn.gearhart@hca5.eclinicaldirectplus.com

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.

• Grand Strand Surgical Specialists, LLC

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1841465804
  Medicare reassignment Care Compare group
• Blue Ocean Medical Group LLC

  • Family Medicine Physician
  • Dededo, GU
  • NPI 1235791203
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grand Strand Regional Medical Center LLC

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1356932867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 210",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724181",
            "telephone_number": "843-497-6348",
            "fax_number": "843-497-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 210",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724181",
            "telephone_number": "843-497-6348",
            "fax_number": "843-497-6351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Harmon Loop Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Dededo",
            "state": "GU",
            "postal_code": "969296544",
            "country_code": "US",
            "telephone_number": "671-633-4447",
            "fax_number": "671-633-4452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "KAITLYN",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GU",
            "license": "129",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Rene Martin, MD
• Jesse Martin, DO
• Patrick C Martin, DC
• Peter Barry Martin, AA
• Alicia Monay Martinez
• Monica Katelynn Martz, PA-C
• Mary Tobin LLC
• Spencer Masiewicz, DO
• Parker Raley Mason, MD
• Gene Matthew Massey, M.D.

• Physician Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.