Individual provider Active NPI

William A Martinez, PA-C

  • Medical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1124161120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15129 Issued in CA
Practice address
2033 W 7TH St
Suite 3
Los Angeles, CA 90057-4073
Phone
(213) 484-2288
Fax
(213) 484-2225
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

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
Medical Physician Assistant 363AM0700X PA15129 CA Primary

Addresses

Primary practice location

2033 W 7TH St
Suite 3
Los Angeles, CA 90057-4073

Mailing address

2033 W 7TH St
Suite3
Los Angeles, CA 90057-4073
Phone (213) 484-2288

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
I20071212000409 CA Practitioner - Physician Assistant 9335239581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritana Medical Clinic,Inc.Group PAC ID 0749370989, 12 clinicians

Practice addresses (Care Compare)

510 S Alvarado St
Los Angeles, CA 90057-2904
Phone (213) 483-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA15129CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritana Medical Clinic 7TH Street Inc Past Accepting new patients
Multispecialty & Vascular Partners Inc PastSince May 16, 2022 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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124161120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 W 7TH ST",
            "address_2": "SUITE3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574073",
            "telephone_number": "213-484-2288",
            "fax_number": "213-484-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 W 7TH ST",
            "address_2": "SUITE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574073",
            "telephone_number": "213-484-2288",
            "fax_number": "213-484-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.