Individual provider Active NPI

Martin H Stancil, PA-C

  • Physician Assistant
  • Athens, GA
National Provider Identifier
1639475700
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6057 Issued in GA
Practice address
125 King Ave
Athens, GA 30606-6734
Phone
(706) 549-1663
Fax
(706) 546-8792
NPI assigned
Feb 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 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 6057 GA Primary

Addresses

Primary practice location

125 King Ave
Athens, GA 30606-6734

Mailing address

1765 Old West Broad St BLDG 2-200
Athens, GA 30606-2887
Phone (706) 549-1663

Other practice location 1

1765 Old West Broad St
Athens, GA 30606-2853
Phone (706) 549-1663

Other identifiers 1

IdentifierTypeStateIssuer
12328584OtherCAQH NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address martin.stancil.1@28045.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110719000278 GA Practitioner - Physician Assistant 8820068620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Orthopedic Clinic, PAGroup PAC ID 5991600181, 70 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1765 Old W Broad St
Athens, GA 30606-2853
Phone (706) 549-1663

2600 Compass Rd
Glenview, IL 60026-8001

9152 Hwy 278 NE
Covington, GA 30014-7010
Phone (678) 342-9339

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6057GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Orthopedic Clinic, PA CurrentSince Jun 11, 2011 Accepting new patients
Athens Orthopedic Clinic, PA CurrentSince Jun 11, 2011 Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients

Locations

1765 Old West Broad St
Ste 200
Athens, GA 30606
Phone (706) 433-4088

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1765 Old West Broad St
Bldg 2
Athens, GA 30606
Phone (706) 548-2060

1765 Old West Broad St
Athens, GA 30606
Phone (706) 548-6881

125 King Ave
Athens, GA 30606

1765 Old West Broad St
Bldg 2-200
Athens, GA 30606
Phone (706) 433-4088

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

1031 Lake Country Dr
Greensboro, GA 30642

1680A Eatonton Rd
Madison, GA 30650
Phone (404) 282-5600

Interoperability endpoints

  • Direct secure messaging: mstancil@aoc1036.srs-direct.com
  • Direct secure messaging: martin.stancil.1@28045.direct.athenahealth.com

Organizations & group practices 4

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": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1639475700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 KING AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066734",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1765 Old West Broad St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062853",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANCIL",
        "first_name": "MARTIN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-07",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "12328584",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "martin.stancil.1@28045.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address",
            "address_1": "1765 Old West Broad St",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306062853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.