Active NPI
Joseph E Martin, PA
- Medical Physician Assistant
- Fort Bragg, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA15841
- Practice address
- 205 South St
Fort Bragg, CA 95437-5540 - Phone
- (707) 964-1251
- Fax
- (707) 961-2722
- NPI assigned
- Apr 3, 2007
- Last updated
- Sep 7, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA15841 | CA | Primary |
Addresses
Primary practice location
205 South St
Fort Bragg, CA 95437-5540
Mailing address
205 South St
Fort Bragg, CA 95437-5540
Phone (707) 964-1251
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EF732Z | Other | CA | PTAN |
| FHC03967F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
700 River Dr
Fort Bragg, CA 95437-5403
Phone (707) 961-1234
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.98 of 100
- Quality
- 73.31
- Promoting interoperability
- 92
- Improvement activities
- 40
- Cost
- 62
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA15841 | CA | MD | Medical Physician Assistant |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mendocino Coast District Hospital
- Critical Access Hospital
- Fort Bragg, CA
- NPI 1538113725
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mendocino Coast District Hospital
- Critical Access Hospital
- Fort Bragg, CA
- NPI 1538113725
-
dba Adventist Health Howard Memorial
- Critical Access Hospital
- Willits, CA
- NPI 1356339543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1649391889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 SOUTH ST",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954375540",
"telephone_number": "707-964-1251",
"fax_number": "707-961-2722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 SOUTH ST",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954375540",
"telephone_number": "707-964-1251",
"fax_number": "707-961-2722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JOSEPH",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA15841",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "EF732Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC03967F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Bragg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.