Domingo Carlo Disraeli Martinez, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

36914 Issued in CA

Practice address

1534 Euclid St Apt 2
Santa Monica, CA 90404-3331

Phone

(626) 260-4755

NPI assigned

Aug 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Domingo-Carlo Disraeli Martinez Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1043242563
  NPD

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1154637387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 EUCLID ST APT 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043331",
            "telephone_number": "626-260-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 EUCLID ST APT 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043331",
            "telephone_number": "626-260-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "DOMINGO CARLO",
        "middle_name": "DISRAELI",
        "name_prefix": "Dr.",
        "credential": "DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2023-09-26",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DOMINGO-CARLO",
            "last_name": "MARTINEZ",
            "middle_name": "DISRAELI",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Robert Sacks Martin, MD
• William Joshua Martin, MD
• Alexa Cristal Martinez
• Arturo Martinez
• Clarisa Martinez, DPT
• Erendira Martinez
• Jonathan Martinez, M.A.
• Nancy Martinez
• Patricia E. Martinez, MFT
• Rafael Alexander Martinez Jr.

• Physical Therapist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.