Individual provider Active NPI

Holly R Martin, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1760488035
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103120 Issued in NC
Practice address
10931 Raven Ridge Rd
Ste 101
Raleigh, NC 27614-6499
Phone
(919) 870-6600
Fax
(919) 870-1610
NPI assigned
Jun 22, 2005
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 103120 NC Primary

Addresses

Primary practice location

10931 Raven Ridge Rd
Ste 101
Raleigh, NC 27614-6499

Mailing address

PO Box 23329
New York, NY 10087-3329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20041215000790 NC Practitioner - Physician Assistant 9931166550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Dermatology PAGroup PAC ID 7012971609, 52 clinicians

Practice addresses (Care Compare)

10931 Raven Ridge Rd
Suite 101
Raleigh, NC 27614-6499
Phone (919) 870-6600

4201 Lake Boone TRL
Suite 200
Raleigh, NC 27607-7511
Phone (919) 782-2152

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103120NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Arundel Dermatology Affiliates PC Past Accepting new patients
Preston Medical Associates PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hmartin@aadermaffiliates.emadirect.md

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1760488035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10931 RAVEN RIDGE RD",
            "address_2": "STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146499",
            "telephone_number": "919-870-6600",
            "fax_number": "919-870-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "HOLLY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.