Individual provider Active NPI

Mary Martineau

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1124404504
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5965 S 900 E
Salt Lake City, UT 84121-1720
Phone
(801) 263-7138
NPI assigned
Aug 7, 2015
Last updated
Aug 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

5965 S 900 E
Salt Lake City, UT 84121-1720

Mailing address

5965 S 900 E
Salt Lake City, UT 84121-1720
Phone (801) 263-7138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150828000606 UT Practitioner - Clinical Social Worker 4284940768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

275 E S Temple
Suite 350
Salt Lake City, UT 84111-1272
Phone (801) 425-4187

4525 S 2300
Suite 102
Holladay, UT 84117-4682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mary M Martineau LCSW LLC CurrentSince Aug 26, 2016 Accepting new patients

Locations

275 E South Temple
Ste 350
Salt Lake City, UT 84111
Phone (512) 767-0685

4525 S 2300 E
Ste 102
Salt Lake City, UT 84117
Phone (801) 425-4187

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1124404504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEAU",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.