Individual provider Active NPI

Bethany Martin

  • Physician Assistant
  • Canton, OH
National Provider Identifier
1407431950
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007192 Issued in OH
Practice address
1330 Mercy Dr NW Ste 101
Canton, OH 44708-2624
Phone
(330) 588-4676
Fax
(330) 588-4677
NPI assigned
Mar 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.007192 OH Primary

Addresses

Primary practice location

1330 Mercy Dr NW Ste 101
Canton, OH 44708-2624

Mailing address

28891 State Route 172
Kensington, OH 44427-9732
Phone (330) 692-0239

Other practice location 1

141 N Forge St
Akron, OH 44304-1407
Phone (330) 375-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211014002685 OH Practitioner - Physician Assistant 3577961903 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

110 Dublin Dr
Dover, OH 44622-7805
Phone (330) 343-0753

1320 Mercy Dr NW
Canton, OH 44708-2614
Phone (330) 489-1145

1330 Mercy Dr NW
Canton, OH 44708-2626
Phone (330) 489-1000

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Union Hospital Hospital, Dover, OH, CCN 360010
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.007192OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jun 30, 2024 Accepting new patients

Locations

1330 Mercy Dr NW
Ste 319
Canton, OH 44708
Phone (330) 580-4706

1330 Mercy Dr NW
Ste 101
Canton, OH 44708
Phone (330) 244-8505

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

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.

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1407431950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28891 STATE ROUTE 172",
            "city": "KENSINGTON",
            "state": "OH",
            "postal_code": "444279732",
            "telephone_number": "330-692-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW STE 101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082624",
            "telephone_number": "330-588-4676",
            "fax_number": "330-588-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 N Forge St",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443041407",
            "country_code": "US",
            "telephone_number": "330-375-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BETHANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.