TANNER MARTIN – Physician Assistant, NPI 1285452540

TANNER MARTIN is a healthcare provider. based in Lawton, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5674 (OK). The NPI Number for TANNER MARTIN is 1285452540

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
TANNER MARTIN
NPI
1285452540
Phone
(405) 990-2070
Address
8005 NW NORWICK AVE
Enumeration Date
26 September 2024
Last Update Date
8 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5803555242
Graduation Year
2025 (1 year ago)
PAC ID
1557848959
Group Practice PAC ID
2668373689
Professional Enrollment ID
I20260115003805
Address ID
OK735059695LA5404XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

1,797 PHYSICIAN ASSISTANT in OK

Provider Addresses for TANNER MARTIN

  • 8005 NW NORWICK AVE

    LAWTON, OK 735054033

    Phone: (405) 990-2070

    Type: Mailing

  • 110 NW 31ST ST STE 201

    LAWTON, OK 735056100

    Phone: (580) 585-5549

    Fax: (580) 699-8223

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2026-01-15

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
I20260115003805IPhysician AssistantOKTBD

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 73505)

Loading plans...

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: 2668373689View full group profile
NameSpecialtyState
Internal MedicineOK
Registered Dietitian Or Nutrition ProfessionalOK
Internal MedicineOK
Clinical Social WorkerOK
Registered Dietitian Or Nutrition ProfessionalOK
Nurse PractitionerOK
Nurse PractitionerOK
Nurse PractitionerOK
P S Y C H I A T R YOK
Family PracticeOK

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What unique ID ties claims to TANNER MARTIN?
NPI 1285452540 is assigned to TANNER MARTIN under the national enumeration system.
Is TANNER MARTIN's NPI currently valid?
The extract we use shows TANNER MARTIN as active.
What kind of provider is TANNER MARTIN?
The page reflects Physician Assistant for TANNER MARTIN. Clinical services aligned with this taxonomy classification.
Where is TANNER MARTIN's primary listing?
We display Lawton, Oklahoma because that is what the record indicates for TANNER MARTIN.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

Similar Providers

Pecan Valley Drive, Lawton, Comanche County, Oklahoma, 73505, United States
NPI: 1033116363

LONNIE SCHOLL (PA-C)

Physician Assistant
1821 N WASHINGTON ST
NPI: 1043264575

HOPE KING (PA)

Physician Assistant
2405, Northwest 35th Street, Lawton, Comanche County, Oklahoma, 73505, United States
NPI: 1356358501

SHERRYL A. EVANS (PA)

Physician Assistant
3106, Northwest Arlington Avenue, Lawton, Comanche County, Oklahoma, 73505, United States
NPI: 1144232570

EDYE A CALDERON (PAC)

Physician Assistant
PO BOX 785
NPI: 1669577474

Unknown Individual

Physician Assistant
PO BOX 785
NPI: 1437244977
2503, Northeast Heritage Creek Drive, Lawton, Comanche County, Oklahoma, 73507, United States
NPI: 1376629311

LEONARD SIMS MCNEIL (P.A.)

Physician Assistant
40, Burton Hills Boulevard, Nashville, Davidson County, Tennessee, 37215, United States
NPI: 1598830200

MR. JESSE LEE GOODMAN (PA-C)

Physician Assistant
Lawton Indian Hospital, 1515, Northeast Lawrie Tatum Road, Sneed Acres, Lawton, Comanche County, Oklahoma, 73505, United States
NPI: 1699843342