Willard Fraser Martin II

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C0000605 Issued in MD

Practice address

9901 Medical Center Dr
Rockville, MD 20850-3357

Phone

(301) 946-6688

NPI assigned

Jul 31, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: wmartin159687@direct.hopkinsmedicine.org

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1558527333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16905 HOSKINSON RD",
            "city": "POOLESVILLE",
            "state": "MD",
            "postal_code": "208372280",
            "telephone_number": "301-972-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503357",
            "telephone_number": "301-946-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WILLARD",
        "middle_name": "FRASER",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0000605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9901 Medical Center Dr",
            "city": "Rockville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208503357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Martin, PA-C
• Samiah Martin
• Suzanna E. Martin, M.D., PH.D.
• Tina Martin
• Tyreonna Martin
• Kimberly Jane Martindell, RN
• Adriana Laperle Martineau, AU.D
• Keren Martinez Aguilar
• Karen Martinez Campos
• Astrid Martinez Galdamez

• Surgical Physician Assistant in Rockville, MD
• Providers in Rockville, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.