Individual provider Active NPI

Cynthia Martinez, LMSW

  • Social Worker
  • Bridgeport, CT
National Provider Identifier
1104475060
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4722 Issued in CT
Practice address
743 South Ave
Bridgeport, CT 06604-5810
Phone
(203) 330-6010
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4722 CT Primary

Addresses

Primary practice location

743 South Ave
Bridgeport, CT 06604-5810

Mailing address

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 330-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CT, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230911003570 NJ Practitioner - Clinical Social Worker 9032573928 Reassigns benefits to 1 organization
I20230918002888 CT Practitioner - Clinical Social Worker 9032573928 Reassigns benefits to 1 organization
I20231109003881 DC Practitioner - Clinical Social Worker 9032573928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4722CTMDSocial Worker
44SC06160900NJMDClinical Social Worker
0904014417VAMDClinical Social Worker
12768CTMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South-West Community Health Center, Inc CurrentSince Sep 8, 2019 Accepting new patients
Grow Healthcare Group of New Jersey PC CurrentSince Aug 9, 2023 Accepting new patients
Grow Healthcare Group PA CurrentSince Jul 7, 2023 Accepting new patients
Effective School Solutions LLC Past Accepting new patients

Locations

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1104475060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SOUTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066045810",
            "telephone_number": "203-330-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CYNTHIA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "4722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.