Individual provider Active NPI

Michelle Padilla Martinez, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1104310002
Registry record updated Oct 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95007512 Issued in CA
Practice address
445 S Figueroa St FL 31
Los Angeles, CA 90071
Phone
(888) 731-8994
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95007512 CA
Nurse Practitioner 363L00000X 95007512 CA Primary

Addresses

Primary practice location

445 S Figueroa St FL 31
Los Angeles, CA 90071

Mailing address

445 S Figueroa St FL 31
Los Angeles, CA 90071-1602
Phone (888) 731-8994

Other practice location 1

100 Ucla Medical Plz Ste 310
Los Angeles, CA 90024-6999
Phone (310) 267-7838

Other practice location 2

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 582-7137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190325001850 CA Practitioner - Nurse Practitioner 1254671472 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95007512CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Dec 9, 2019 Accepting new patients
Antaki & Associates Infectious Disease Medical Group Inc CurrentSince Mar 25, 2019 Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 101
Glendale, CA 91205
Phone (323) 242-5299

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Interoperability endpoints

  • Direct secure messaging: michelle.martinez.1@27069.direct.athenahealth.com

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729382400000",
    "number": "1104310002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 S FIGUEROA ST FL 31",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900711602",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S FIGUEROA ST FL 31",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90071",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Ucla Medical Plz Ste 310",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900246999",
            "country_code": "US",
            "telephone_number": "310-267-7838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042303",
            "country_code": "US",
            "telephone_number": "310-582-7137",
            "fax_number": "310-582-7140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MICHELLE",
        "middle_name": "PADILLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2024-10-20",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95007512",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.