Individual provider Active NPI

Michelle Martin

  • Adult Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1053731406
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1037046 Issued in TX
Practice address
6655 Travis St Ste 600
Houston, TX 77030-1341
Phone
(713) 795-0074
Fax
(713) 795-5203
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1037046 TX Primary
Adult Health Nurse Practitioner 363LA2200X RN2284776 MA

Addresses

Primary practice location

6655 Travis St Ste 600
Houston, TX 77030-1341

Mailing address

6655 Travis St Ste 600
Houston, TX 77030-1341
Phone (713) 795-0074

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104000188 TX Practitioner - Nurse Practitioner 3173842341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Action Therapy Centers LimitedGroup PAC ID 3173433265, shared by 3 NPIs, 76 clinicians
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

4009 Bellaire Blvd
Houston, TX 77025-1168

7505 Main St
Suite 290
Houston, TX 77030-4523
Phone (713) 795-0074

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

Hospital & facility affiliations

  • Houston Methodist Hospital Hospital, Houston, TX, CCN 450358
  • Memorial Hermann Houston Physicians Hospital Hospital, Webster, TX, CCN 670008
  • Houston Methodist West Hospital Hospital, Houston, TX, CCN 670077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1037046TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Dec 8, 2021 Accepting new patients
Privia Medical Group Gulf Coast PLLC CurrentSince Dec 8, 2021 Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

6655 Travis St
Ste 600
Houston, TX 77030
Phone (713) 500-8260

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: michelle.martin.1@8042.direct.athenahealth.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1053731406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 TRAVIS ST STE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301341",
            "telephone_number": "713-795-0074",
            "fax_number": "713-795-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 TRAVIS ST STE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301341",
            "telephone_number": "713-795-0074",
            "fax_number": "713-795-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1037046",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2284776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.