Jessica Martin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2840 E Los Angeles Ave
Simi Valley, CA 93065

Phone

(805) 526-8360

NPI assigned

Jan 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jessica.martin.p9@direct.regal.nextgenshare.com

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.

• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  Medicare reassignment
• Daniel Ghiyam M D Inc

  • Family Medicine Physician
  • Simi Valley, CA
  • NPI 1114245842
  Medicare reassignment

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1770090201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "93065",
            "telephone_number": "805-526-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "PA55234",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark M. Kang, M.D.
• Sevak Semik Marout, DDS
• Rachel Marriott, LM, CPM
• Marsden & Leung a Professional Corporation
• Alexandra Martin
• Michael Martin, C
• Eric Emilio Martinez, ATC, EMT
• Kenneth J Martinez, LMFT
• Prisma Martinez, M.S., LMFT
• Adebisi Martins-Adekunle

• Physician Assistant in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.