Individual provider Active NPI

Kerry Ann Martin, PA-C

  • Physician Assistant
  • Odenton, MD
National Provider Identifier
1609358944
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0006936 Issued in MD
Practice address
1110 Annapolis Rd
Odenton, MD 21113-1602
Phone
(443) 351-3917
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 C0006936 MD Primary

Addresses

Primary practice location

1110 Annapolis Rd
Odenton, MD 21113-1602

Mailing address

7809 Wisconsin Ave
Bethesda, MD 20814-3523

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MDExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190205003296 DC Practitioner - Physician Assistant 7113265885 Reassigns benefits to 2 organizations
I20220712003435 MD Practitioner - Physician Assistant 7113265885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, shared by 26 NPIs, 258 clinicians

Practice addresses (Care Compare)

10210 Reisterstown Rd
Owings Mills, MD 21117-3606
Phone (410) 902-6776

10424 Baltimore Ave
Beltsville, MD 20705-2321
Phone (240) 542-5987

1110 Annapolis Rd
Odenton, MD 21113-1602
Phone (443) 351-3917

15459 Annapolis Rd
Bowie, MD 20715-1847
Phone (240) 544-0676

2051 W St
Annapolis, MD 21401-3006
Phone (443) 603-0758

6333 Baltimore Nat Pike
Catonsville, MD 21228-3910
Phone (443) 514-1361

7116 Ritchie Hwy
Glen Burnie, MD 21061-2904
Phone (443) 577-0277

726 Rockville Pike
Rockville, MD 20852-1133
Phone (240) 238-0411

8105 Ritchie Hwy
Pasadena, MD 21122-3905
Phone (443) 573-0564

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0006936MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Maryland Medical Group PLLC CurrentSince Sep 19, 2024 Accepting new patients
Minuteclinic LLC Physician Assistant CurrentSince Jun 20, 2022 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Sep 19, 2024 Accepting new patients
Patient First Maryland Medical Group, PLLC CurrentSince Sep 19, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2601 Riva Rd
Annapolis, MD 21401
Phone (410) 571-2090

7809 Wisconsin Ave
Bethesda, MD 20814
Phone (301) 986-9144

10095 Ward Rd
Dunkirk, MD 20754
Phone (410) 257-0191

1110 Annapolis Rd
Odenton, MD 21113
Phone (443) 351-3917

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

10210 Reisterstown Rd
#12302
Owings Mills, MD 21117
Phone (410) 902-6776

7955 Tuckerman Ln
Rockville, MD 20854
Phone (301) 299-3717

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

5000 Cox Rd
Apt 205
Glen Allen, VA 23060

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBBBCD
  • Direct secure messaging: mdexchange@patientfirstclinics.com

Organizations & group practices 5

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1609358944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7809 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ANNAPOLIS RD",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131602",
            "telephone_number": "443-351-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KERRY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1110 Annapolis Rd",
            "city": "Odenton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211131602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Odenton, MD

Sources for this page

Verify at the official NPI Registry.