Individual provider Active NPI

Mary Gloria Martinez

  • In Home Supportive Care Agency
  • El Paso, TX
National Provider Identifier
1083179568
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
012684 Issued in TX
Practice address
8933 Ankerson St
El Paso, TX 79904-1320
Phone
(915) 629-2079
Fax
(915) 755-7191
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 012684 TX
Personal Care Attendant 3747P1801X 012684 TX
In Home Supportive Care Agency 253Z00000X 012684 TX Primary

Addresses

Primary practice location

8933 Ankerson St
El Paso, TX 79904-1320

Mailing address

PO Box 640726
El Paso, TX 79904-0726
Phone (915) 474-3537

Other identifiers 1

IdentifierTypeStateIssuer
1669646402MedicaidTX

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
012684TXMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Simpatico Cielo Vista Operations LLC Current Accepting new patients
Simpatico East Operations LLC Current Accepting new patients
Simpatico East Operations, LLC PastSince Nov 16, 2021 Accepting new patients
Dharma Home Care, Inc. In Home Supportive Care Past Accepting new patients

Organizations & group practices 4

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1083179568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640726",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799040726",
            "telephone_number": "915-474-3537",
            "fax_number": "915-755-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8933 ANKERSON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799041320",
            "telephone_number": "915-629-2079",
            "fax_number": "915-755-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARY",
        "middle_name": "GLORIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "012684",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "TX",
            "license": "012684",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": "012684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669646402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.