Martin Madrigal, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17142 Issued in CA

Practice address

5404 Moreno St
Suite N
Montclair, CA 91763-1667

Phone

(909) 949-4400

Fax

(909) 949-4441

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: vidahealthclinic.martinmadrigal@136751.advancedmd-direct.com

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.

• Montclair Vida Health Clinic PC

  • Health Service Clinic/Center
  • Montclair, CA
  • NPI 1699034827
  Medicare reassignment
• Leon Forefront Medical Services Inc.

  • Family Medicine Physician
  • Montclair, CA
  • NPI 1588016364
  NPD (past)
• Multi Health Care Medical Group Inc.

  • Family Medicine Physician
  • South Gate, CA
  • NPI 1861418576
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1043371636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 MORENO ST",
            "address_2": "SUITE N",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631667",
            "telephone_number": "909-949-4400",
            "fax_number": "909-949-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 MORENO ST",
            "address_2": "SUITE N",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631667",
            "telephone_number": "909-949-4400",
            "fax_number": "909-949-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRIGAL",
        "first_name": "MARTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA17142",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee L Mack
• Melissa Mackay, OT R/L
• Quentinn Macklin
• Tina Louise Macmaster
• Elisabeth Madrigal
• Veronica Magallanes
• Cindy Magana
• Vanessa Magdaleno
• Michael D Magdato, O.D.
• Mahipal M. Shah, M.D.,P.C.

• Medical Physician Assistant in Montclair, CA
• Providers in Montclair, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.