Individual provider Active NPI

Tamara Martin, PA

  • Physician Assistant
  • Oneida, NY
National Provider Identifier
1972594117
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009766 Issued in NY
Practice address
321 Genesee St
Oneida, NY 13421-2611
Phone
(315) 363-6000
NPI assigned
Nov 4, 2005
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009766 NY Primary

Addresses

Primary practice location

321 Genesee St
Oneida, NY 13421-2611

Mailing address

321 Genesee St
Oneida, NY 13421-2611
Phone (315) 363-6000

Other identifiers 1

IdentifierTypeStateIssuer
02528027MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 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
I20040503000783 NY Practitioner - Physician Assistant 3375531080 Reassigns benefits to 1 organization
I20180618002735 GA Practitioner - Physician Assistant 3375531080 Reassigns benefits to 1 organization
Practice locations: Albany, GA

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oneida Health Systems IncGroup PAC ID 5395794713, 28 clinicians

Practice addresses (Care Compare)

321 Genesee St
Oneida, NY 13421-2611
Phone (315) 363-6000

323 Genesee St
Oneida, NY 13421-2611
Phone (315) 361-2119

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Feb 1, 2018 Accepting new patients
Phoebe Dorminy Family Care CurrentSince Feb 1, 2018 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

425 W 3rd Ave
Ste 410
Albany, GA 31701
Phone (229) 312-0707

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

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.

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1972594117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 GENESEE ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212611",
            "telephone_number": "315-363-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 GENESEE ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212611",
            "telephone_number": "315-363-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TAMARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02528027",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, NY

Sources for this page

Verify at the official NPI Registry.