Individual provider Active NPI

Joshua Aaron Martin, PA

  • Surgical Physician Assistant
  • Klamath Falls, OR
National Provider Identifier
1659898633
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA185011 Issued in OR
Practice address
2200 Bryant Williams Dr Ste 1
Klamath Falls, OR 97601-1121
Phone
(541) 274-5729
Fax
(541) 274-5745
NPI assigned
Aug 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA185011 OR Primary

Addresses

Primary practice location

2200 Bryant Williams Dr Ste 1
Klamath Falls, OR 97601-1121

Mailing address

2200 Bryant Williams Dr Ste 1
Klamath Falls, OR 97601-1121
Phone (541) 274-5729

Other practice location 1

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6211

Other identifiers 1

IdentifierTypeStateIssuer
500732144MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20171026001780 OR Practitioner - Physician Assistant 2567738164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2301 Clairmont Dr
Klamath Falls, OR 97601-7104
Phone (541) 274-8630

2821 Daggett Ave
Suite 100
Klamath Falls, OR 97601-1106
Phone (541) 274-6733

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6221

Hospital & facility affiliations

  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Oct 5, 2022 Accepting new patients

Locations

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

2200 Bryant Williams Dr
Klamath Falls, OR 97601
Phone (541) 883-3391

3000 Bryant Williams Dr
Ste 110
Klamath Falls, OR 97601
Phone (541) 274-2345

2200 Bryant Williams Dr
Ste 1
Klamath Falls, OR 97601
Phone (541) 884-3677

Organizations & group practices 2

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": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1659898633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BRYANT WILLIAMS DR STE 1",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011121",
            "telephone_number": "541-274-5729",
            "fax_number": "541-274-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BRYANT WILLIAMS DR STE 1",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011121",
            "telephone_number": "541-274-5729",
            "fax_number": "541-274-5745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2865 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "telephone_number": "541-274-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOSHUA",
        "middle_name": "AARON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA185011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500732144",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.