Individual provider Active NPI

Triscia Martin, PA

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1477643088
Registry record updated Jan 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004046 Issued in MD
Practice address
5200 Eastern Ave
MFL West Tower, 6TH FLR
Baltimore, MD 21224-2734
Phone
(410) 550-5018
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6033775-1206 UT
Medical Physician Assistant 363AM0700X C0004046 MD Primary
Medical Physician Assistant 363AM0700X PA030646 DC
Medical Physician Assistant 363AM0700X 009695 NY

Addresses

Primary practice location

5200 Eastern Ave
MFL West Tower, 6TH FLR
Baltimore, MD 21224-2734

Mailing address

5200 Eastern Ave
MFL West Tower, 6TH FLR
Baltimore, MD 21224-2734
Phone (415) 550-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6033775-1206UTMDPhysician Assistant
PA030646DCMDMedical Physician Assistant
C0004046MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists, Inc. Past Accepting new patients
California Emergency Physicians Medical Group, a Professional Corp Past Accepting new patients

Organizations & group practices 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294444800000",
    "number": "1477643088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 EASTERN AVE",
            "address_2": "MFL WEST TOWER, 6TH FLR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242734",
            "telephone_number": "415-550-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 EASTERN AVE",
            "address_2": "MFL WEST TOWER, 6TH FLR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242734",
            "telephone_number": "410-550-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TRISCIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "6033775-1206",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004046",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030646",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.