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DR. ALISIA SHART MARTIN MD
NPI 1619004850
Psychiatry & Neurology - Child & Adolescent Psychiatry in Jacksonville Beach, FL

Active since February 27, 2007Opted out of Medicare · through Apr 1, 2027
1538 THE GREENS WAY, SUITE 101, JACKSONVILLE BEACH, FL 32250(904) 543-0161(904) 543-9172 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Alisia Shart Martin Md NPPES

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

DR. ALISIA SHART MARTIN MD (NPI 1619004850) is an individual child & adolescent psychiatry provider in Jacksonville Beach, Florida, licensed in Florida (ME0071972) and active in the NPI registry since February 2007. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1619004850
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. ALISIA SHART MARTINCredential: MD
Location Address1538 THE GREENS WAY, SUITE 101Jacksonville Beach, FL 32250-2499
Mailing Address1538 The Greens Way, Suite 101Jacksonville Beach, FL 32250-2499 · (904) 543-0161 · Fax (904) 543-9172
Phone(904) 543-0161
Fax(904) 543-9172
Sole ProprietorYes
Enumeration DateFebruary 27, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1619004850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in FL · ME0071972
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
1538 THE GREENS WAY, Jacksonville Beach, FL 32250
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Alisia Shart Martin Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2019 through April 1, 2027.

Opt-Out Effective DateApril 1, 2019
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 8

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

DR. CYNTHIA P STEVENS PH.D.
Psychologist
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161
MARSH LANDING BEHAVIORAL GROUP INC
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161
DR. CHERALYN PAYTON LEEBY PH.D.
Marriage & Family Therapist
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161
LISA SELVIG AMATO PH.D.
Psychologist (Clinical Child & Adolescent)
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161
SABRINA M CACERES DO
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1538 THE GREENS WAY, 101
JACKSONVILLE, FL 32250
Duval County (904) 543-0161
MRS. CATHERINE ANN BOBENRIETH M.D
Psychiatry & Neurology (Psychiatry)
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161
DR. MARK CHRISTOPHER TOMASKI M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161
MRS. KIMBERLY ANN HAZOURI-YEARY LMHC
Counselor (Mental Health)
1538 THE GREENS WAY, SUITE 101
JACKSONVILLE BEACH, FL 32250
Duval County (904) 543-0161

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 Alisia Martin's NPI number?

The NPI number for Alisia Martin is 1619004850. It was assigned to this individual provider in the NPPES registry on February 27, 2007.

Where is Alisia Martin located?

Alisia Martin practices at 1538 The Greens Way Suite 101, Jacksonville Beach, FL 32250. The listed phone number is (904) 543-0161.

What is Alisia Martin's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Alisia Martin enrolled in Medicare?

No. Alisia Martin has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Alisia Martin was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.