Individual provider Active NPI

Bethany Joy Martin, PA-C

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1427711266
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114977 Issued in FL
Practice address
2415 University Pkwy Ste 219
Sarasota, FL 34243-2809
Phone
(941) 413-0834
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 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 PA9114977 FL Primary

Addresses

Primary practice location

2415 University Pkwy Ste 219
Sarasota, FL 34243-2809

Mailing address

2415 University Pkwy Ste 219
Sarasota, FL 34243-2809
Phone (941) 413-0834

Other practice location 1

3314 Henderson Blvd Ste 205
Tampa, FL 33609-2934
Phone (941) 413-0834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2023 through Oct 1, 2027

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1427711266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY PKWY STE 219",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432809",
            "telephone_number": "941-413-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY PKWY STE 219",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432809",
            "telephone_number": "941-413-0834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3314 Henderson Blvd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336092934",
            "country_code": "US",
            "telephone_number": "941-413-0834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BETHANY",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.