TERESA D MARTIN (PA-C) – Physician Assistant, NPI 1104890672
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
Provider Addresses for TERESA D MARTIN (PA-C)
1855 GATTIS SCHOOL RD
ROUND ROCK, TX 786647428
Phone: (512) 238-6268
Type: Location
1209, Highknoll Lane, Georgetown, Williamson County, Texas, 78628, United States
GEORGETOWN, TX 786281015
Phone: (904) 468-0111
Type: Mailing
CVS Pharmacy, 501, University Boulevard, Round Rock, Williamson County, Texas, 78665, United States
ROUND ROCK, TX 786651048
Phone: (512) 238-6268
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: 2022-08-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160727001209 | I | Physician Assistant | CA | TBD |
| I20170413002026 | I | Physician Assistant | NV | TBD |
| I20190109001579 | I | Physician Assistant | TX | TBD |
| I20220812000381 | I | Physician Assistant | MT | TBD |
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.
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 78664)
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