Tatiana Alexandra Martinez, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9776 Issued in GA

Practice address

451 Northolt Pkwy
Suwanee, GA 30024-4362

Phone

(648) 680-4290

NPI assigned

Jul 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Carenow Urgent Care LLCGroup PAC ID 6800158544, 44 clinicians

DawoudGroup PAC ID 1951434422, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dawoud

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1255650941
  Medicare reassignment Care Compare group
• Jacksonville Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1447771670
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656115200000",
    "number": "1922625482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 HILLSIDE DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013116",
            "telephone_number": "404-307-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 NORTHOLT PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244362",
            "telephone_number": "648-680-4290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 Pine St",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305016754",
            "country_code": "US",
            "telephone_number": "770-503-1369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TATIANA",
        "middle_name": "ALEXANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2022-06-25",
        "certification_date": "2022-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "9776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Nicole Marquis, OTR/L
• Anna Christina Marra, CNM
• Shelley L Martin, DC
• Lupita Martinez-Heranadez, RBT
• Brenley Martinez, LAMFT
• Mary Grace Thomas, PH.D.,P.C.
• Mary Loretta House, LLC
• Shanae Mason, PA-C
• Nicholas Massa
• Jennifer Masters

• Medical Physician Assistant in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.