KEVIN L MARTIN PA-C NPI 1205067220

NPI Information

NPI: 1205067220
Provider Name: KEVIN L MARTIN, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
114 WOODLAND ST
DEPARTMENT OF SURGERY
HARTFORD, CT
ZIP 06105
Phone: (860) 714-6581
Get Directions

Kevin L Martin, PA-C is a surgical physician assistant in Hartford, CT with 15 years of experience. Kevin L Martin, PA-C NPI is 1205067220. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE
Graduation Year:2009

The provider's business location address is:

114 WOODLAND ST
DEPARTMENT OF SURGERY
HARTFORD, CT
ZIP 06105-208
Phone: (860) 714-6581
Fax: (860) 714-8311

The NPI 1205067220 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 enumeration date for this NPI number is 8/7/2009 and was last updated on 8/31/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA4019	MASSACHUSETTS	No
2	363AS0400X	Physician Assistant	Surgical	002579	CONNECTICUT	Yes

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

NPI Synchronization or Removal

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