KELLY MARIE MARTIN (APRN) – Family Nurse Practitioner, NPI 1033939764

KELLY MARIE MARTIN (APRN) is a healthcare provider. based in Madeira beach, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 11035940 (FL). The NPI Number for KELLY MARIE MARTIN (APRN) is 1033939764

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KELLY MARIE MARTIN (APRN)
NPI
1033939764
Phone
(954) 849-0254
Address
577 NORMANDY RD
Enumeration Date
16 October 2024
Last Update Date
16 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
72744519923222
Graduation Year
2024 (2 years ago)
PAC ID
2062940687
Group Practice PAC ID
9436108099
Professional Enrollment ID
I20250110000911
Address ID
FL337563356CL455XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for KELLY MARIE MARTIN (APRN)

  • 577 NORMANDY RD

    MADEIRA BEACH, FL 337082315

    Phone: (954) 849-0254

    Type: Mailing

  • 455 PINELLAS ST STE 400

    CLEARWATER, FL 337563356

    Phone: (727) 445-1911

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250110000911INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33708)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436108099View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)FL
Physician AssistantFL
Cardiovascular Disease (Cardiology)FL
Cardiovascular Disease (Cardiology)FL
Nurse PractitionerFL
Cardiovascular Disease (Cardiology), Internal MedicineFL
Interventional CardiologyFL
Cardiovascular Disease (Cardiology), Internal MedicineFL
Interventional Cardiology, Cardiovascular Disease (Cardiology)FL
Interventional Cardiology, Cardiovascular Disease (Cardiology)FL

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELLY MARIE MARTIN (APRN)?
KELLY MARIE MARTIN (APRN) — NPI 1033939764 — is the standard way to identify this listing.
Does the file indicate KELLY MARIE MARTIN (APRN) is practicing under active NPI?
Directory data currently reports KELLY MARIE MARTIN (APRN) as active.
What taxonomy line describes KELLY MARIE MARTIN (APRN)?
For research purposes, treat KELLY MARIE MARTIN (APRN) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does KELLY MARIE MARTIN (APRN) serve?
KELLY MARIE MARTIN (APRN)'s listing highlights Madeira Beach, Florida; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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