Mallory B Martin, NP - Medicare Nurse Practitioner in Edmond, OK

Mallory B Martin, NP is a medicare enrolled "Nurse Practitioner - Family" in Edmond, Oklahoma. She went to University Of South Alabama College Of Medicine and graduated in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lykos Medical Llc, Legacy Healthcare Services Inc and her current practice location is 2417 Nw 174th St, Edmond, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 255-6706.

Mallory B Martin is licensed to practice in Colorado (license number 1257) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1073154787.

Contact Information

Mallory B Martin, NP
2417 Nw 174th St,
Edmond, OK 73012-7108
(405) 255-6706
Not Available



Provider's Profile

Full NameMallory B Martin
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location2417 Nw 174th St, Edmond, Oklahoma
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mallory B Martin attended and graduated from University Of South Alabama College Of Medicine in 2019
  NPI Data:
  • NPI Number: 1073154787
  • Provider Enumeration Date: 10/03/2019
  • Last Update Date: 03/16/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 9830518281
  • Enrollment ID: I20210322002500

Medical Identifiers

Medical identifiers for Mallory B Martin such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073154787NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 113578 (Oklahoma)Secondary
363LF0000XNurse Practitioner - Family 1257 (Colorado)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lykos Medical Llc09415580357
Legacy Healthcare Services Inc21633397222654

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mallory B Martin allows following entities to bill medicare on her behalf.
Entity NameLykos Medical Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215423124
PECOS PAC ID: 0941558035
Enrollment ID: O20180806003125

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mallory B Martin is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mallory B Martin, NP
7610 N Union Blvd Ste 150,
Colorado Springs, CO 80920-3800

Ph: (719) 434-8810
Mallory B Martin, NP
2417 Nw 174th St,
Edmond, OK 73012-7108

Ph: (405) 255-6706

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Nurse Practitioner Nurses in Edmond, OK

Michelle Kathleen Merrell, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3800 S. Blvd,, Edmond, OK 73013
Phone: 405-905-9888    
Catherine Marie Kindt, APRN, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2177 Venezia Cir, Edmond, OK 73034
Phone: 580-695-1605    
Karyl S. Knopps, A.R.N.P.
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 2820 N Kelly Ave, Ste 200, Edmond, OK 73003
Phone: 405-726-8000    Fax: 405-726-8101
Lisa Louise Spence, APRN-CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1208 W 15th St, Edmond, OK 73013
Phone: 405-340-2100    Fax: 405-340-1184
Elizabeth Stanfield Carradini, DNP, APRN, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1520 S Bryant Ave, Edmond, OK 73013
Phone: 405-348-7982    
Kelli Rebecca Lawrence,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 200 N Bryant Ave Ste 120, Edmond, OK 73034
Phone: 405-832-6881    Fax: 833-941-1685
Dr. Magdalyn Boegler, DNP, APRN, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 7225 Skipping Stone Dr, Edmond, OK 73034
Phone: 405-887-3556    

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