Elisamuel Martinez Diaz

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024087 Issued in NY

Practice address

10 Davenport Ave BSMT
New Rochelle, NY 10805-3634

Phone

(787) 396-0975

NPI assigned

Apr 12, 2006

Last updated

Feb 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Ponce School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Integrated Family Health NP & Psychology PLLC

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1093336703

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1033173745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVENPORT AVE BSMT",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108053634",
            "telephone_number": "787-396-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DAVENPORT AVE BSMT",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108053634",
            "telephone_number": "787-396-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ DIAZ",
        "first_name": "ELISAMUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2559",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erick Fabian Martin
• Maureen Martin, R.N.
• Shavon Martin
• Soncarae Monique Martin
• Timothy Martin
• Iris Margoth Martinez, MSED
• Jacqueline Alexis Martinez
• Jason Noel Martinez
• Jose Martinez, MS
• Luis Alfredo Martinez

• Clinical Psychologist in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.