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MR. RYAN JACK MARTIN PAC NPI 1124163894


NPI Information

NPI: 1124163894
Provider Name: MR. RYAN JACK MARTIN, PAC
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
9301 N CENTRAL EXPY STE 500
DALLAS, TX
ZIP 75231
Phone: (214) 220-2468
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MR. Ryan Jack Martin, PAC is a surgical physician assistant in Dallas, TX with 22 years of experience. MR. Ryan Jack Martin, PAC NPI is 1124163894. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduation Year:2002

The provider's business location address is:

9301 N CENTRAL EXPY STE 500
DALLAS, TX
ZIP 75231-805
Phone: (214) 220-2468
Fax: (469) 232-9738

The NPI 1124163894 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

The enumeration date for this NPI number is 2/21/2007 and was last updated on 6/1/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AS0400XPhysician AssistantSurgicalPA03455TEXASYes
2363A00000XPhysician AssistantNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1281283601MEDICAIDTEXAS
2281283602MEDICAIDTEXAS
3281283603MEDICAIDTEXAS
4PA03455OTHERTEXASSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.