Individual provider Active NPI

Cecilia Ann Martin

  • Ambulatory Care Registered Nurse
  • Bronx, NY
National Provider Identifier
1053827675
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
452839-1 Issued in NY
Practice address
1250 Waters PL
Bronx, NY 10461-2720
Phone
(929) 263-3302
NPI assigned
Dec 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 452839-1 NY Primary

Addresses

Primary practice location

1250 Waters PL
Bronx, NY 10461-2720

Mailing address

PO Box 467
White Plains, NY 10602-0467
Phone (914) 589-5628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
452839-1NYMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1053827675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 467",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106020467",
            "telephone_number": "914-589-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "929-263-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CECILIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "452839-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.