NPIMap

Individual provider Active NPI

Kimberly Marie Martinez, ANP

  • Adult Health Nurse Practitioner
  • McMinnville, OR
National Provider Identifier
1083637680
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
094006411N3 Issued in OR
Practice address
2700 SE Stratus Ave Unit 304
McMinnville, OR 97128-6257
Phone
(503) 434-6090
Fax
(503) 474-3306
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 094006411N3 OR Primary

Addresses

Primary practice location

2700 SE Stratus Ave Unit 304
McMinnville, OR 97128-6257

Mailing address

2700 SE Stratus Ave Unit 304
McMinnville, OR 97128-6257
Phone (503) 434-6090

Other identifiers 1

IdentifierTypeStateIssuer
210707MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000746 OR Practitioner - Nurse Practitioner 1658363395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Willamette Valley Clinics LLCGroup PAC ID 6103729314, 39 clinicians

Practice addresses (Care Compare)

254 NE Norton LN
McMinnville, OR 97128-8470
Phone (503) 472-9002

2700 SE Stratus Ave
McMinnville, OR 97128-6255
Phone (503) 435-6441

2700 SE Stratus Ave
Unit 402
McMinnville, OR 97128-6258
Phone (503) 434-1110

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Salem, OR, CCN 387136
  • Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302
  • Salem Hospital Hospital, Salem, OR, CCN 380051
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
094006411N3ORMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Valley Clinics LLC CurrentSince Jan 20, 2015 Accepting new patients

Locations

2700 SE Stratus Ave
Unit 302
McMinnville, OR 97128
Phone (503) 474-2565

2700 SE Stratus Ave
Unit 304
McMinnville, OR 97128
Phone (503) 434-6090

2700 SE Stratus Ave
Unit 402
McMinnville, OR 97128
Phone (503) 434-1110

254 NE Norton Ln
McMinnville, OR 97128
Phone (503) 472-6161

Interoperability endpoints

  • Direct secure messaging: kimberly.martinez.1@1814.direct.athenahealth.com

Organizations & group practices 1

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1083637680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE UNIT 304",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286257",
            "telephone_number": "503-434-6090",
            "fax_number": "503-474-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE UNIT 304",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286257",
            "telephone_number": "503-434-6090",
            "fax_number": "503-474-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "094006411N3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210707",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.