CHANISHA J. MARTIN – Hospitalist Physician, NPI 1285924498

CHANISHA J. MARTIN is a healthcare provider. based in Pontiac, Michigan. specializing in HOSPITALIST. They hold a License No. MD-17589 (HI). The NPI Number for CHANISHA J. MARTIN is 1285924498

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
CHANISHA J. MARTIN
NPI
1285924498
Phone
(313) 909-5270
Address
251 TUCKER ST
Enumeration Date
10 April 2011
Last Update Date
24 May 2021

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
8084320000
Graduation Year
2011 (15 years ago)
PAC ID
6103048293
Group Practice PAC ID
7618880667
Professional Enrollment ID
I20141105000003
Address ID
HI968191469HO3288XRDXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Other namesUpdated within 12 months

2,392 HOSPITALIST in IL

Provider Addresses for CHANISHA J. MARTIN

  • 251 TUCKER ST

    PONTIAC, MI 483411076

    Phone: (313) 909-5270

    Type: Mailing

  • 1740 W TAYLOR ST

    CHICAGO, IL 606127232

    Phone: (866) 600-2273

    Type: Location

  • 3288 MOANALUA RD

    HONOLULU, HI 968191469

    Phone: (808) 432-0000

    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: 2014-11-05

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
I20141105000003IHospitalistHITBD

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 48341)

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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: 7618880667View full group profile
NameSpecialtyState
P S Y C H I A T R YCA
O P T O M E T R YHI
-HI
Physician AssistantHI
Emergency MedicineVA
Orthopedic SurgeryHI
Internal MedicineHI
Orthopedic SurgeryHI
-HI
-CO

Reviews

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Frequently asked questions

How is CHANISHA J. MARTIN identified in CMS data?
CMS-hosted NPPES data lists CHANISHA J. MARTIN with NPI 1285924498.
Can I rely on CHANISHA J. MARTIN being an active provider?
As of the registry snapshot, CHANISHA J. MARTIN is marked active.
What is CHANISHA J. MARTIN best known for clinically?
Directory data describes CHANISHA J. MARTIN with Hospitalist Physician. Clinical services aligned with this taxonomy classification.
Where should I expect CHANISHA J. MARTIN on a map?
Expect Pontiac, Michigan as a primary anchor for CHANISHA J. MARTIN unless the record lists multiple sites.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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