Individual provider Active NPI

Kristin Martin, PA-C

  • Medical Physician Assistant
  • Kokomo, IN
National Provider Identifier
1962093344
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10003176A Issued in IN
Practice address
3500 S Lafountain St
Kokomo, IN 46902-3803
Phone
(765) 776-3020
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003176A IN
Medical Physician Assistant 363AM0700X 10003176A IN Primary

Addresses

Primary practice location

3500 S Lafountain St
Kokomo, IN 46902-3803

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

3 Municipal Dr
Fishers, IN 46038-1574
Phone (317) 567-5045

Other practice location 2

1000 E Main St
Danville, IN 46122-1948
Phone (317) 745-4451

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmartin450895@direct-PRD.stelizabeth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210720001821 IN Practitioner - Physician Assistant 4284037870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003176AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hendricks County Hospital CurrentSince Aug 25, 2025 Accepting new patients
Cep America LLC CurrentSince Dec 1, 2021 Accepting new patients
Cep America LLC Physician Assistant CurrentSince Dec 1, 2021 Accepting new patients
Hendricks County Hospital CurrentSince Aug 25, 2025 Accepting new patients
Hendricks County Hospital Past Accepting new patients
Hendricks County Hospital Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510

8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500

1000 E Main St
Danville, IN 46122
Phone (317) 745-3420

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Interoperability endpoints

  • FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
  • Direct secure messaging: kmartin450895@direct-prd.stelizabeth.com

Organizations & group practices 8

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1962093344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-776-3020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Municipal Dr",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460381574",
            "country_code": "US",
            "telephone_number": "317-567-5045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Main St",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IN",
            "postal_code": "461221948",
            "country_code": "US",
            "telephone_number": "317-745-4451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003176A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10003176A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmartin450895@direct-PRD.stelizabeth.com",
            "affiliation": "N",
            "address_1": "1000 E Main St",
            "city": "Danville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461221948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.