Individual provider Active NPI

Peter Barry Martin, AA

  • Anesthesiologist Assistant
  • Myrtle Beach, SC
National Provider Identifier
1962289322
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(809) 692-1000
NPI assigned
Sep 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2000-00037 NC
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

23 Berkeley St
Nashua, NH 03064-1933
Phone (603) 459-5865

Other practice location 1

3714 Guardian Ave Ste W
Morehead City, NC 28557-2975
Phone (252) 247-0314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, SC, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231209000272 VT Practitioner - Anesthesiology Assistant 6002265527 Reassigns benefits to 1 organization
I20240103000027 SC Practitioner - Anesthesiology Assistant 6002265527 Reassigns benefits to 1 organization
I20250310001332 NC Practitioner - Anesthesiology Assistant 6002265527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Coast Anesthesia Services PCGroup PAC ID 3971887167, 71 clinicians

Practice addresses (Care Compare)

3714 Guardian Ave
Suite W
Morehead City, NC 28557-2975
Phone (252) 247-0314

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
125SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC CurrentSince Feb 1, 2025 Accepting new patients
American Anesthesiology of North Carolina, PLLC CurrentSince Feb 1, 2025 Accepting new patients
Atlantic Coast Anesthesia Services P.C. CurrentSince Jan 22, 2024 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

3714 Guardian Ave
Ste W
Morehead City, NC 28557
Phone (252) 247-0314

3714 Guardian Ave
Morehead City, NC 28557
Phone (252) 247-0314

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

120 Hospital Dr
Bennington, VT 05201
Phone (802) 440-4077

100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1962289322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BERKELEY ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030641933",
            "telephone_number": "603-459-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "809-692-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3714 Guardian Ave Ste W",
            "address_purpose": "LOCATION",
            "city": "Morehead City",
            "state": "NC",
            "postal_code": "285572975",
            "country_code": "US",
            "telephone_number": "252-247-0314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PETER",
        "middle_name": "BARRY",
        "credential": "AA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NC",
            "license": "2000-00037",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.