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Jaclyn E Martin

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

200 Lothrop St, Pittsburgh, PA 15213-2536

PECOS Enrollment

This provider is enrolled in PECOS as JACLYN MARTIN.

Based on the most recent information from CMS, provider Jaclyn E Martin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1376113621
Provider Type
Individual
Full Name
Martin, Jaclyn E
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
6/29/2021
Last Updated
9/22/2021

Contact Information

Practice Location

200 Lothrop St, Pittsburgh, PA 15213-2536

(412) 647-2345

Unlisted Fax

Mailing Location

5322 Wismer Rd, Pipersville, PA 18947-1424

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Jaclyn E Martin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Petrucci, Julia

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Depierre, Sara E

Kunkle, Lauren

Ferguson, Tara Rosemary

Niedermeier, Briana

Hanlon, Ellie

Vanlieshout, Adam

Munson, Olivia Katherine