Individual provider Active NPI

John R. Martinez, P.T.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1053467209
Registry record updated Feb 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023784-1 Issued in NY
Practice address
258 W 91St St
Suite 1-B
New York, NY 10024-1108
Phone
(212) 875-8345
Fax
(212) 875-0143
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 023784-1 NY Primary

Addresses

Primary practice location

258 W 91St St
Suite 1-B
New York, NY 10024-1108

Mailing address

258 W 91St St
Suite 1-B
New York, NY 10024-1108
Phone (212) 875-8345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000678 NY Practitioner - Physical Therapist in Private Practice 2567533789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 W 55TH St
Suite 13 F
New York, NY 10019-5350
Phone (212) 875-8345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023784NYMDGeneral Practice Dentistry
023784-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Expert, PLLC Physical Therapist CurrentSince May 19, 2008 Accepting new patients

Locations

258 W 91st St
Apt 1B
New York, NY 10024
Phone (212) 875-8345

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": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391817600000",
    "number": "1053467209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 W 91ST ST",
            "address_2": "SUITE 1-B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241108",
            "telephone_number": "212-875-8345",
            "fax_number": "212-875-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 W 91ST ST",
            "address_2": "SUITE 1-B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241108",
            "telephone_number": "212-875-8345",
            "fax_number": "212-875-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2014-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023784-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.