Mary Kathleen Martinez, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN-62222 Issued in NM

Practice address

4425 Juan Tabo Blvd NE Ste 112
Albuquerque, NM 87111-2684

Phone

(505) 503-6800

Fax

(866) 530-1835

NPI assigned

Dec 8, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Elemental Health and Wellness Center LLCGroup PAC ID 0446481881, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25877/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elemental Health and Wellness Center LLC

  • Marriage & Family Therapist
  • Albuquerque, NM
  • NPI 1891125183

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Something Different Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
  • NPI 1245987049
  Medicare reassignment NPD Authorized official
• Sage Neuroscience Center Inc

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1578644415
  Medicare reassignment NPD
• Stay the Course Counseling

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1740037985
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1013513779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112681",
            "telephone_number": "505-503-6800",
            "fax_number": "866-530-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 JUAN TABO BLVD NE STE 112",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112684",
            "telephone_number": "505-503-6800",
            "fax_number": "866-530-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "APRN-62222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Martinez
• Marissa Amanda Martinez
• Marissa Raquel Martinez, RPH
• Martin Anthony Martinez, PHARM D
• Mary A Martinez, MS,RD,LD
• Mary T Martinez
• Matthew Martinez, CCSS
• Matthew Martinez, DMD
• Mayra Martinez, MA
• Megan Martinez, OTR

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.