Individual provider Active NPI

Jeremy David Martinez, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1043499551
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A101936 Issued in CA
Practice address
300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-2211
Phone
(310) 267-6810
NPI assigned
Oct 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A101936 CA Primary

Addresses

Primary practice location

300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-2211

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

1849 Sawtelle Blvd Ste 670
Los Angeles, CA 90025-7082
Phone (310) 478-6006

Other practice location 2

631A Maple Ave
Los Angeles, CA 90014-2211
Phone (213) 514-1456

Other identifiers 1

IdentifierTypeStateIssuer
CB290220OtherMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
76.01
Promoting interoperability
100
Improvement activities
40
Cost
56.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101936CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Psychiatry CurrentSince Oct 6, 2018 Accepting new patients

Locations

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

300 UCLA Medical Plz
Ste 2200
Los Angeles, CA 90095
Phone (310) 267-6810

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1043499551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "866-569-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UCLA MEDICAL PLZ STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952211",
            "telephone_number": "310-267-6810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1849 Sawtelle Blvd Ste 670",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900257082",
            "country_code": "US",
            "telephone_number": "310-478-6006",
            "fax_number": "310-478-6117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "631A Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900142211",
            "country_code": "US",
            "telephone_number": "213-514-1456",
            "fax_number": "866-569-5017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A101936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB290220",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.