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KELLY MARTIN M.D.
NPI 1174767065
Pediatrics - Pediatric Critical Care Medicine in Philadelphia, PA

Active since April 23, 2009PECOS Enrolled
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 7C26, PHILADELPHIA, PA 19104(215) 590-7430 Get Directions Write a Review

NPPES record last updated: July 10, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kelly Martin M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY MARTIN M.D. (NPI 1174767065) is an individual pediatric critical care medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT201919) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174767065
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NameKELLY MARTINCredential: M.D.
Location Address34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 7C26Philadelphia, PA 19104
Mailing Address34th Street And Civic Center Boulevard, Suite 7c26Philadelphia, PA 19104 · (215) 590-7430
Phone(215) 590-7430
Sole ProprietorNo
Enumeration DateApril 23, 2009
Last NPPES UpdateJuly 10, 2012
✔ NPI 1174767065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in PA · MT201919
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
34TH STREET AND CIVIC CENTER BOULEVARD, Philadelphia, PA 19104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Martin M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Martin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Children's Anesthesiology Associates, Ltd
Same address
Pain Medicine
3401 CIVIC CENTER BLVD
Philadelphia, PA 19104
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Childrens Anesthesiology Associates Ltd
  • 216 clinicians in this Medicare group
NPI 1215048491 (215) 590-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN BROWN CRNA
Nurse Anesthetist, Certified Registered
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 9329
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1858
CHERYL BRENNEMAN
Nurse Practitioner (Pediatrics, Critical Care)
34TH STREET AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104
Philadelphia County (917) 478-3378
ALISON REED PERATE MD
Anesthesiology (Pediatric Anesthesiology)
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 9329
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1858
LORI ORTMAN CRNA
Nurse Anesthetist, Certified Registered
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 9329
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1867
MARGARET EMILY SAMUELS-KALOW MD
Pediatrics (Pediatric Emergency Medicine)
34TH STREET AND CIVIC CENTER BOULEVARD, CHILDREN'S HOSPITAL OF PHILADELPHIA, EMERG. DEPT.
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1959
RAMESH KODAVATIGANTI M.D.
Anesthesiology
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 9329
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1867
DAVID R JOBES MD
Anesthesiology (Pediatric Anesthesiology)
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 9329
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1867
MS. SUSAN M WIGHTMAN-HENTZ APN
Nurse Practitioner (Pediatrics)
34TH STREET AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1719

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Martin's NPI number?

The NPI number for Kelly Martin is 1174767065. It was assigned to this individual provider in the NPPES registry on April 23, 2009.

Where is Kelly Martin located?

Kelly Martin practices at 34th Street And Civic Center Boulevard Suite 7c26, Philadelphia, PA 19104. The listed phone number is (215) 590-7430.

What is Kelly Martin's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Kelly Martin enrolled in Medicare?

Yes. Kelly Martin is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Martin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Martin reassigns Medicare benefits to Children's Anesthesiology Associates, Ltd (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Martin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Martin was last updated on July 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.