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Kathleen M Marty

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3 Medical Plaza Dr, #140, Roseville, CA 95661-3087

PECOS Enrollment

This provider is enrolled in PECOS as KATHLEEN MARTY.

Based on the most recent information from CMS, provider Kathleen M Marty is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1043315146
Provider Type
Individual
Full Name
Marty, Kathleen M
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
9/13/2006
Last Updated
7/27/2015

Contact Information

Practice Location

3 Medical Plaza Dr, #140, Roseville, CA 95661-3087

(916) 797-4715

(916) 797-4716

Mailing Location

10470 Old Placerville Rd, Suite 100, Sacramento, CA 95827-2539

(800) 470-0071

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA10584 California

Kathleen M Marty

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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