Individual provider Active NPI

Kimberly Diane Martin, PT

  • Physical Therapist
  • Harlingen, TX
National Provider Identifier
1083706295
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1070845 Issued in TX
Practice address
595 Sesame Dr West
Harlingen, TX 78550-7962
Phone
(956) 428-5440
Fax
(956) 428-3375
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1070845 TX Primary

Addresses

Primary practice location

595 Sesame Dr West
Harlingen, TX 78550-7962

Mailing address

595 W Sesame Dr
Harlingen, TX 78550-7962
Phone (956) 428-5440

Other practice location 1

1300 Wildrose Ln
Brownsville, TX 78520-8600
Phone (956) 542-2845

Other identifiers 4

IdentifierTypeStateIssuer
204544800OtherTXACS DEPARTMENT OF LABOR
134682101OtherTXVALLEY HEALTH PLANS
8T2359OtherTXBLUE CROSS BLUE SHIELD
166501001MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607001638 TX Practitioner - Physical Therapist in Private Practice 6901889427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Texas Medical School at San Antonio, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Rehabilitation Services IncGroup PAC ID 8820071343, 8 clinicians
Total Rehabilitation of Harlingen LTDGroup PAC ID 5496730251, 10 clinicians

Practice addresses (Care Compare)

1300 Wildrose LN
Brownsville, TX 78520-8600
Phone (956) 542-2845

595 W Sesame Dr
Harlingen, TX 78550-7962
Phone (956) 428-5440

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
0
Improvement activities
40
Cost
75.94

Merit-based Incentive Payment System (MIPS)

Final score
57.35 of 100Reported as group
Quality
0
Improvement activities
40
Cost
79.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT1070845TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehabilitation Services Inc Physical Therapist CurrentSince Feb 9, 2004 Accepting new patients
Total Rehabilitation of Harlingen LTD Physical Therapist CurrentSince Feb 9, 2004 Accepting new patients
Saldana Supply Co. LLC Physical Therapist Past Accepting new patients

Locations

1300 Wildrose Ln
Brownsville, TX 78520
Phone (956) 542-2845

4430 E 14th St
Unit E
Brownsville, TX 78521
Phone (956) 542-2845

1327 E Washington Ave
Harlingen, TX 78550
Phone (956) 208-9307

312 E Harrison Ave
Ste A
Harlingen, TX 78550

595 W Sesame Dr
Harlingen, TX 78550
Phone (956) 230-1605

Organizations & group practices 3

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1083706295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 W SESAME DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785507962",
            "telephone_number": "956-428-5440",
            "fax_number": "956-428-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 SESAME DR WEST",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785507962",
            "telephone_number": "956-428-5440",
            "fax_number": "956-428-3375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Wildrose Ln",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TX",
            "postal_code": "785208600",
            "country_code": "US",
            "telephone_number": "956-542-2845",
            "fax_number": "956-548-9019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-07-14",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "PT1070845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS DEPARTMENT OF LABOR",
            "identifier": "204544800",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALLEY HEALTH PLANS",
            "identifier": "134682101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8T2359",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166501001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.