Individual provider Active NPI

Jose Eduardo San Martin, MD.

  • Obstetrics & Gynecology Physician
  • Shenandoah, TX
National Provider Identifier
1053576371
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
P3436 Issued in TX
Practice address
286 Ed English Dr. Unit C
Shenandoah, TX 77385
Phone
(281) 651-2090
Fax
(281) 607-5700
NPI assigned
Jul 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP84955 TX
Obstetrics & Gynecology Physician 207V00000X P3436 TX Primary

Addresses

Primary practice location

286 Ed English Dr. Unit C
Shenandoah, TX 77385

Mailing address

286 Ed English Dr. Unit C
Shenandoah, TX 77385
Phone (281) 651-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130530000640 TX Practitioner - Obstetrics/Gynecology 8921246075 Practice locations: The Woodlands, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP84955TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
First Family Clinic, Inc. Past Accepting new patients
San Martin OB GYN & Womens Healthcare P a Obstetrics & Gynecology PastSince Jan 26, 2013 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jsanmartin113060@directhoustonmethodist.org

Organizations & group practices 2

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": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1053576371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 ED ENGLISH DR. UNIT C",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "77385",
            "telephone_number": "281-651-2090",
            "fax_number": "281-607-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 ED ENGLISH DR. UNIT C",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "77385",
            "telephone_number": "281-651-2090",
            "fax_number": "281-607-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN MARTIN",
        "first_name": "JOSE",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP84955",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P3436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.