MATTIE NICHOLE MARTIN (CRNA, MSN) – Registered Nurse, NPI 1366099053

MATTIE NICHOLE MARTIN (CRNA, MSN) is a healthcare provider. based in Bethlehem, Pennsylvania. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA, MSN. They hold a License No. RN621992 (PA). The NPI Number for MATTIE NICHOLE MARTIN (CRNA, MSN) is 1366099053

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
MATTIE NICHOLE MARTIN (CRNA, MSN)
NPI
1366099053
Phone
Not provided
Address
PO BOX 5520
Enumeration Date
19 August 2019
Last Update Date
4 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4349477700
Graduation Year
2019 (7 years ago)
PAC ID
2769803741
Group Practice PAC ID
6204188113
Professional Enrollment ID
I20241010000253
Address ID
VA245012184LY2401XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness85
Years active:6State licenses:4Digital endpointsOther names

1,888 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in VA

Provider Addresses for MATTIE NICHOLE MARTIN (CRNA, MSN)

  • Bethléem, Charreau des Capucins, Wespin, Neffe, Dinant, Namur, Wallonia, 5500, Belgium

    BETHLEHEM, PA 180150520

    Phone:

    Type: Mailing

  • 2401 ATHERHOLT RD

    LYNCHBURG, VA 245012184

    Phone:

    Type: Mailing

  • Saint Luke's University Hospital - Bethlehem Campus, 801, Ostrum Street, Bethlehem, Lehigh County, Pennsylvania, 18015, United States

    BETHLEHEM, PA 180151000

    Phone: (484) 526-4000

    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: 2024-10-10

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20200529000383ICertified Registered Nurse Anesthetist (Crna)PATBD
I20241010000253ICertified Registered Nurse Anesthetist (Crna)VATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2525$0
00812Anesthesia for exam of colon using an endoscope2222$0
00811Anesthesia for other procedure on large bowel using an endoscope1313$0
View full utilization report →

Insurance plans in this area (ZIP 18015)

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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: 6204188113View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YSC
Certified Registered Nurse Anesthetist (Crna)VA
A N E S T H E S I O L O G YVA
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)VA
Anesthesiology, Pain ManagementVA
Certified Registered Nurse Anesthetist (Crna)VA

Reviews

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Frequently asked questions

Does MATTIE NICHOLE MARTIN (CRNA, MSN) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MATTIE NICHOLE MARTIN (CRNA, MSN) uses 1366099053.
Can I rely on MATTIE NICHOLE MARTIN (CRNA, MSN) being an active provider?
As of the registry snapshot, MATTIE NICHOLE MARTIN (CRNA, MSN) is marked active.
What is MATTIE NICHOLE MARTIN (CRNA, MSN)'s specialty?
The listing groups MATTIE NICHOLE MARTIN (CRNA, MSN) with Registered Nurse. Clinical services aligned with this taxonomy classification.
What area does MATTIE NICHOLE MARTIN (CRNA, MSN) serve?
MATTIE NICHOLE MARTIN (CRNA, MSN)'s listing highlights Bethlehem, Pennsylvania; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.