Individual provider Active NPI

Allyson K Martin, PA

  • Physician Assistant
  • Redding, CA
National Provider Identifier
1528272069
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17322 Issued in CA
Practice address
2102 Civic Center Dr
Redding, CA 96001-2704
Phone
(530) 241-1144
Fax
(530) 241-1142
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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 PA17322 CA Primary

Addresses

Primary practice location

2102 Civic Center Dr
Redding, CA 96001-2704

Mailing address

2102 Civic Center Dr
Redding, CA 96001-2704
Phone (530) 241-1144

Other identifiers 1

IdentifierTypeStateIssuer
PA17322MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040713001638 CA Practitioner - Physician Assistant 0143208850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redding RancheriaGroup PAC ID 7810969847, 32 clinicians
Mohamed H Khan MD IncGroup PAC ID 6608815808, 9 clinicians

Practice addresses (Care Compare)

1441 Liberty St
Redding, CA 96001-0811
Phone 53022427001740

2425 Sonoma St
Redding, CA 96001-3026
Phone (530) 241-1144

3305 Placer St
Suite B
Redding, CA 96001-2378
Phone (530) 225-6805

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
81.77
Improvement activities
40
Cost
74.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17322CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redding Rancheria CurrentSince Nov 1, 2018 Accepting new patients
Redding Rancheria Current Accepting new patients

Locations

3184 Churn Creek Rd
Redding, CA 96002
Phone (530) 224-2700

1441 Liberty St
Redding, CA 96001
Phone (530) 224-2700

4174 Ashby Ct
Shasta Lake, CA 96019
Phone (530) 224-2700

81 Arbuckle Ct
Weaverville, CA 96093
Phone (530) 623-0021

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 2

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1528272069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 CIVIC CENTER DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012704",
            "telephone_number": "530-241-1144",
            "fax_number": "530-241-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 CIVIC CENTER DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012704",
            "telephone_number": "530-241-1144",
            "fax_number": "530-241-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALLYSON",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17322",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.