Kelsey Elise Martin, PA-C

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4165 Blackhawk Plaza Cir Ste 100
Danville, CA 94506-4691

Phone

(925) 736-7070

Fax

(925) 736-7075

NPI assigned

Oct 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: kmartin169472@ehr.johnmuirhealth.com

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.

• Bass Medical Group

  • Specialist
  • Walnut Creek, CA
  • NPI 1154401941
  NPD (past)
• Bass Medical Group

  • Obstetrics & Gynecology Physician
  • Walnut Creek, CA
  • NPI 1174253405
  NPD (past)
• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  NPD (past)

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1588444541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR STE 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064691",
            "telephone_number": "925-736-7070",
            "fax_number": "925-736-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR STE 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064691",
            "telephone_number": "925-736-7070",
            "fax_number": "925-736-7075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21030 Redwood Rd",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465920",
            "country_code": "US",
            "telephone_number": "510-247-8281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3424 Camino Tassajara",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "CA",
            "postal_code": "945064680",
            "country_code": "US",
            "telephone_number": "925-309-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELSEY",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Mariella, M.D.
• Marilyn S. Kwolek MD, PC
• Mark Graham, DDS, Inc.
• Julie Mark, RPH
• Christyn Marshall, DPM
• Jisela Martinez
• Vincent John Martinez, RESPIRATORY THERAPIS
• Jane Massengill
• Linda Mauch
• Anita Marie May

• Student in an Organized Health Care Education/Training Program in Danville, CA
• Providers in Danville, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.