Individual provider Active NPI

Kim Ho Martinsen, PA

  • Physician Assistant
  • New Port Richey, FL
National Provider Identifier
1780927210
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5340 Gulf Dr
Suite 105
New Port Richey, FL 34652-3950
Phone
(727) 849-0222
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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 Primary

Addresses

Primary practice location

5340 Gulf Dr
Suite 105
New Port Richey, FL 34652-3950

Mailing address

5340 Gulf Dr
Suite 105
New Port Richey, FL 34652-3950
Phone (727) 849-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140905001572 FL Practitioner - Physician Assistant 5395963235 Reassigns benefits to 2 organizations

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1780927210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 GULF DR",
            "address_2": "SUITE 105",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346523950",
            "telephone_number": "727-849-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 GULF DR",
            "address_2": "SUITE 105",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346523950",
            "telephone_number": "727-849-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINSEN",
        "first_name": "KIM",
        "middle_name": "HO",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.