Individual provider Active NPI

Daniel Martin, PA-C

  • Physician Assistant
  • Centennial, CO
National Provider Identifier
1508533720
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006952 Issued in CO
Practice address
5555 E Arapahoe Rd
Centennial, CO 80122-2312
Phone
(303) 338-4545
NPI assigned
Aug 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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 PA.0006952 CO Primary

Addresses

Primary practice location

5555 E Arapahoe Rd
Centennial, CO 80122-2312

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545

Other practice location 1

7036 S Elm Ct
Centennial, CO 80122-2459
Phone (303) 877-0592

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220106000360 CO Practitioner - Physician Assistant 2668863366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

10350 E Dakota Ave
Denver, CO 80247-1314

10350 E Dakota Avenue B
Kaiser Permanente High
Denver, CO 80247-1314
Phone (303) 338-4545

10350 E Dakota Avenue C
Kaiser Permanente Highline Chemical
Denver, CO 80247-1314
Phone (303) 338-4545

5555 E Arapahoe Rd
Kaiser Permanente Arapahoe Medical
Centennial, CO 80122-2312
Phone (303) 338-4545

National Provider Directory

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

Organizations & group practices 1

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1508533720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E ARAPAHOE RD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801222312",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7036 S Elm Ct",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801222459",
            "country_code": "US",
            "telephone_number": "303-877-0592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "C-CDA",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5555 E Arapahoe Rd",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801222312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.