NPIMap

Organization Active NPI

Dagoberto Martinez, Mdpa

  • Obstetrics & Gynecology Physician
  • Brownsville, TX
National Provider Identifier
1073569059
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DAGOBERTO MARTINEZ, MDPA
Practice address
95 E Price Rd BLDG a
Brownsville, TX 78521-3531
Phone
(956) 544-2001
Fax
(956) 546-4567
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Authorized official

Name
Ms. Maryann Fore, WHCNP
Title
Cheif Operating Officer
Phone
(956) 544-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

95 E Price Rd BLDG a
Brownsville, TX 78521-3531

Mailing address

95 E Price Rd BLDG a
Brownsville, TX 78521-3531
Phone (956) 544-2001

Other identifiers 2

IdentifierTypeStateIssuer
9002000000A99J0OtherTXBLUE CROSS AND BLUE SHIEL
081598701MedicaidTX

Other names 1

  • Clinica Santa Maria Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040424000320 TX Part B Supplier - Clinic/Group Practice 2365438249 Receives reassigned benefits from 10 practitioners
Practice locations: Brownsville, TX

National Provider Directory

National Provider Directory

Locations

95 E Price Rd
Bldg A
Brownsville, TX 78521
Phone (956) 504-6080

3855 Southmost Rd
Bldg A
Brownsville, TX 78521

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1073569059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 E PRICE RD BLDG A",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785213531",
            "telephone_number": "956-544-2001",
            "fax_number": "956-546-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 E PRICE RD BLDG A",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785213531",
            "telephone_number": "956-544-2001",
            "fax_number": "956-546-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAGOBERTO MARTINEZ, MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "FORE",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "CHEIF OPERATING OFFICER",
        "authorized_official_telephone_number": "956-544-2001",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "WHCNP"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "9002000000A99J0",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081598701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Santa Maria",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinica Santa Maria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.