TAMMY PRUITT MARTINEZ (PA-C) – Physician Assistant, NPI 1619944154

TAMMY PRUITT MARTINEZ (PA-C) is a healthcare provider. based in Jacksonville, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA00359 (RI). The NPI Number for TAMMY PRUITT MARTINEZ (PA-C) is 1619944154

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
TAMMY PRUITT MARTINEZ (PA-C)
NPI
1619944154
Phone
(045) 538-0950
Address
9130 R G SKINNER PARKWAY
Enumeration Date
3 March 2006
Last Update Date
28 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9045380950
Graduation Year
2004 (22 years ago)
PAC ID
5890735955
Group Practice PAC ID
4880791375
Professional Enrollment ID
I20180202002155
Address ID
FL322569661JA9130XPKWY400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for TAMMY PRUITT MARTINEZ (PA-C)

  • 9130 R G SKINNER PARKWAY

    JACKSONVILLE, FL 32256

    Phone: (045) 538-0950

    Fax: (904) 538-0952

    Type: Location

  • 2 Wake Robin Rd

    Suite 103

    Lincoln, RI 028654241

    Phone: (401) 334-3105

    Fax: (401) 334-1144

    Type: Location

  • 4498 Hendricks Ave

    Jacksonville, FL 322076326

    Phone: (049) 854-1730

    Fax: (904) 402-8000

    Type: Location

  • 4498, Hendricks Avenue, Miramar Terrace, Jacksonville, Duval County, Florida, 32207, United States

    JACKSONVILLE, FL 322076326

    Phone: (904) 854-1730

    Fax: (904) 402-8000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $762.

Total Amount is formed as General ($762) + Research ($0) + Ownership ($0) = $762.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($381).

Total Amount

$762

General + Research + Ownership

Payments

19

Total payment records

General Amount

$762

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2018-02-02

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
I20180202002155IPhysician AssistantFLTBD

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 32256)

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Provider's Procedures

TAMMY PRUITT MARTINEZ (PA-C) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTRI83036Hemoglobin A1C level4425

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: 4880791375View full group profile
NameSpecialtyState
Family PracticeFL
Family PracticeFL
Family PracticeFL

Reviews

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Frequently asked questions

What is TAMMY PRUITT MARTINEZ (PA-C)'s NPI number?
TAMMY PRUITT MARTINEZ (PA-C)'s NPI is 1619944154 — the number used across U.S. healthcare to identify this provider.
Is TAMMY PRUITT MARTINEZ (PA-C) still an active registrant?
TAMMY PRUITT MARTINEZ (PA-C) carries an active NPI according to the public dataset.
How would a patient describe TAMMY PRUITT MARTINEZ (PA-C)'s focus?
For TAMMY PRUITT MARTINEZ (PA-C), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Florida is TAMMY PRUITT MARTINEZ (PA-C) registered?
Use Jacksonville, Florida as the headline location for TAMMY PRUITT MARTINEZ (PA-C) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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