Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theodore Dale Martin, CRNP

Individual provider Family Nurse Practitioner · NPI 1841025418

Theodore Dale Martin, CRNP is a Nurse Practitioner in Erie, Pennsylvania. Qualified in 2024, 2 years ago. Practices with Ucmg LLC, a 258-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2024
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

7200 Peach St Unit 16
Erie, PA 16509-4756
Phone: (814) 877-4110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP030516 (PA)

Record details

NPI number1841025418
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorNo
NPI enumeratedSeptember 4, 2024
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Ucmg Llc — 258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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