KELLIE ST MARTIN – Adult Health Nurse Practitioner, NPI 1598305807

KELLIE ST MARTIN is a healthcare provider. based in Bridgewater, Massachusetts. specializing in NURSE PRACTITIONER. They hold a License No. 2295376 (MA). The NPI Number for KELLIE ST MARTIN is 1598305807

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE ST MARTIN
NPI
1598305807
Phone
(508) 510-0627
Address
110 RIVERVIEW DR
Enumeration Date
14 January 2020
Last Update Date
27 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6172878000
Graduation Year
2019 (7 years ago)
PAC ID
3678976313
Group Practice PAC ID
4284645086
Professional Enrollment ID
I20210719003217
Address ID
MA021252424DO415XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

8,972 NURSE PRACTITIONER in MA

Provider Addresses for KELLIE ST MARTIN

  • 110 RIVERVIEW DR

    BRIDGEWATER, MA 023241967

    Phone: (508) 510-0627

    Type: Mailing

  • 11 TREMONT ST

    KINGSTON, MA 023641231

    Phone: (781) 585-5518

    Type: Location

  • 415 COLUMBIA RD

    DORCHESTER, MA 021252424

    Phone: (617) 287-8000

    Type: Mailing

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: 2021-07-19

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
I20210719003217INurse PractitionerMATBD

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 02324)

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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: 4284645086View full group profile
NameSpecialtyState
-MA
Nurse PractitionerMA
Family PracticeMA
O P T O M E T R YMA
O B S T E T R I C S/ G Y N E C O L O G YMA
Internal MedicineMA
Family PracticeMA
Internal MedicineMA
O P T O M E T R YMA
Family PracticeMA

Reviews

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Frequently asked questions

Can I verify KELLIE ST MARTIN with an NPI only?
You can start verification with NPI 1598305807 for KELLIE ST MARTIN, then check state licensing separately.
Does the file indicate KELLIE ST MARTIN is practicing under active NPI?
Directory data currently reports KELLIE ST MARTIN as active.
What is KELLIE ST MARTIN best known for clinically?
Directory data describes KELLIE ST MARTIN with Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for KELLIE ST MARTIN?
KELLIE ST MARTIN's geographic hint is Bridgewater, Massachusetts in our summary view.
Is the information about KELLIE ST MARTIN up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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