Maddison Martin, PA-S

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56941 Issued in CA

Practice address

2501 E Chapman Ave Ste 100
Orange, CA 92869-3204

Phone

(714) 638-3302

Fax

(714) 633-0519

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmartin1373802@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Dispatchhealth-Ca, PC

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1639752553
  Medicare reassignment
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Mission Viejo, CA
  • NPI 1427305960
  NPD
• Professional Portable Radiologic Services Inc.

  • Physiological Laboratory
  • Houston, TX
  • NPI 1457087991
  NPD (past)

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1952862385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-638-3302",
            "fax_number": "714-633-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-638-3302",
            "fax_number": "714-633-0519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2212 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053870",
            "country_code": "US",
            "telephone_number": "714-571-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2251 N Harbor Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928352601",
            "country_code": "US",
            "telephone_number": "714-449-6230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15855 Pomona Rincon Rd Bldg 4",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917093162",
            "country_code": "US",
            "telephone_number": "909-929-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MADDISON",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartin1373802@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2501 E Chapman Ave Ste 100",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928693204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Martin, SUDCC
• Jan Michelle Martin
• Joan Deanna Martin
• John Martin
• Lashanett Martin
• Melissa Terra Martin, CADC-II
• Michael Martin
• Olivia Martin
• Sarah R Martin, PHD
• Ella Martinetto

• Physician Assistant in Orange, CA
• Providers in Orange, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.