Individual provider Active NPI

James Allen Martin, RPAC,ARNP

  • Medical Physician Assistant
  • Glenville, NY
National Provider Identifier
1801892948
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1330 Issued in NY
Practice address
133 Saratoga Rd
Glenville, NY 12302-4108
Phone
(716) 984-9309
NPI assigned
Jun 23, 2005
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1330 NY Primary
Family Nurse Practitioner 363LF0000X 9242972 FL

Addresses

Primary practice location

133 Saratoga Rd
Glenville, NY 12302-4108

Mailing address

133 Saratoga Rd
Apt. T-05
Glenville, NY 12302-4108
Phone (716) 984-9309

Other identifiers 1

IdentifierTypeStateIssuer
01271498MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091015000377 NY Practitioner - Physician Assistant 8527072743
I20191001000405 NY Practitioner - Nurse Practitioner 8527072743 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1330NYMDMedical Physician Assistant
9242972FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little Falls Hospital CurrentSince Jul 22, 2019 Accepting new patients
Little Falls Hospital Family CurrentSince Jul 22, 2019 Accepting new patients
Family Plus Primary Care,Rpa,PC PastSince Dec 1, 1999 Accepting new patients

Locations

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1801892948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SARATOGA RD",
            "address_2": "APT. T-05",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024108",
            "telephone_number": "716-984-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SARATOGA RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024108",
            "telephone_number": "716-984-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JAMES",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "RPAC,ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "1330",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9242972",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01271498",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenville, NY

Sources for this page

Verify at the official NPI Registry.