AVERY JEA MARTIN NPI 1053967653
Nurse Practitioner in Crittenden, KY

Individual Female Years of Experience 4 Nurse Practitioner PECOS Enrolled Accepts Medicare Approved Payment

About AVERY JEA MARTIN

Avery Martin is a provider established in Crittenden, Kentucky and her medical specialization is Nurse Practitioner with more than 4 years of experience. The NPI number of Avery Martin is 1053967653 and was assigned on August 2019. The practitioner's primary taxonomy code is 363L00000X with license number 3013651 (KY). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1053967653
Provider Name AVERY JEA MARTIN
Provider Location Address405 VIOLET RD CRITTENDEN, KY 41030
Provider Mailing AddressPO BOX 635283 CINCINNATI, OH 45263
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2019
Is Sole Proprietor?No
Enumeration Date08-11-2019
Last Update Date09-24-2020

A nurse practitioner (NP) like Avery Jea Martin is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.Avery Martin is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Avery Martin is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with St Elizabeth Edgewood.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.18 for a new patient copayment and $24.51 for an established patient copayment.



Primary Taxonomy

Taxonomy Code363L00000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.3013651
License StateKY
Taxonomy Description(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Business Address

AVERY JEA MARTIN
405 VIOLET RD
CRITTENDEN, KY
ZIP 41030
Phone: (859) 428-1610
Fax: (859) 428-3923

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Mailing Address

AVERY JEA MARTIN
PO BOX 635283
CINCINNATI, OH
ZIP 45263
Phone:


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID3375963226
PECOS Enrollment IDI20201015001546
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 41030 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$54.72 $168.41 $84.75
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.68 $42.1 $21.18
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.65 $137.34 $98.06
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.16 $34.33 $24.51

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Avery Martin is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ST ELIZABETH EDGEWOOD1 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
(859) 301-2000Acute Care Hospitals180035

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAPRN.CNP.024869OHNo

Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1053967653
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2010318614610
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 0 + 3 + 1 + 8 + 6 + 1 + 4 + 6 + 1 + 0 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1053967653 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1952415788 OSCAR O PEREZ JR. DO
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1356446447DR. PHILLIP LEE KISER M.D.
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268
1891197273 RYAN FREIBERT D.O.
Individual
Neuromusculoskeletal Medicine & OMM405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1063895522 NICOLE ABBOT MD
Individual
Psychiatry & Neurology (Psychiatry)405 VIOLET RD
CRITTENDEN, KY 41030
(859) 301-5901
1780063636 ANDREA CLAIR GIST M.D.
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268
1891285938HEALTHPOINT FAMILY CARE, INC.
Organization
Clinic/Center (Federally Qualified Health Center (FQHC))405 VIOLET RD
CRITTENDEN, KY 41030
(859) 655-6100
1003012428DR. VIRAL PATEL D.O.
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1518989334DR. KATHIE E MORGAN MD
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1942261250DR. BRADFORD ALAN QUATKEMEYER MD
Individual
Family Medicine405 VIOLET RD
CRITTENDEN, KY 41030
(859) 428-1610
1750899142 WILLIAM TRAVIS YOUNG ARNP, FNP-C
Individual
Nurse Practitioner405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268
1366539652MRS. SUZANNE MICHELLE FERNBACH PA-C
Individual
Physician Assistant405 VIOLET RD
CRITTENDEN, KY 41030
(859) 903-0268

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Avery Jea Martin is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.