Individual provider Active NPI

Jenna Patricia Martin, RPA-C

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1578818670
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015706-1 Issued in NY
Practice address
3075 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1236
Phone
(716) 712-0490
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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 015706-1 NY Primary

Addresses

Primary practice location

3075 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1236

Mailing address

3075 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1236
Phone (716) 712-0490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20121207000313 NY Practitioner - Physician Assistant 6305098880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kuwik and Schmit Medical Group LLPGroup PAC ID 1153376371, 5 clinicians

Practice addresses (Care Compare)

3075 Southwestern Blvd
Suite 100
Orchard Park, NY 14127-1236
Phone (716) 712-0490

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015706-1NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jennabiddlecom@oconnormedicalgroup.medentdirect.com

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.

Hospital & facility affiliations 3

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1578818670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 SOUTHWESTERN BLVD STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271236",
            "telephone_number": "716-712-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 SOUTHWESTERN BLVD STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271236",
            "telephone_number": "716-712-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNA",
        "middle_name": "PATRICIA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015706-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.