Individual provider Active NPI

Rolando A Martinez, D.C.

  • Chiropractor
  • Costa Mesa, CA
National Provider Identifier
1124038005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17304 Issued in CA
Practice address
1520 Nutmeg PL
Suite110
Costa Mesa, CA 92626-2501
Phone
(714) 437-9763
Fax
(714) 437-9764
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC17304 CA Primary

Addresses

Primary practice location

1520 Nutmeg PL
Suite110
Costa Mesa, CA 92626-2501

Mailing address

1520 Nutmeg PL
Suite110
Costa Mesa, CA 92626-2501
Phone (714) 437-9763

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000158 CA Practitioner - Chiropractic 6709936883 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC17304CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Health Associates Past Accepting new patients
Center for Better Health a Medical Group, Inc. Past Accepting new patients

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124038005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL",
            "address_2": "SUITE110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262501",
            "telephone_number": "714-437-9763",
            "fax_number": "714-437-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL",
            "address_2": "SUITE110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262501",
            "telephone_number": "714-437-9763",
            "fax_number": "714-437-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ROLANDO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.