Individual provider Active NPI

Isaac Emilio Martinez, PTA

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1164182010
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTA51140 Issued in CA
Practice address
8031 Fruitridge Rd Ste Aandb
Sacramento, CA 95820-6758
Phone
(916) 669-9038
NPI assigned
Dec 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTA51140 CA Primary

Addresses

Primary practice location

8031 Fruitridge Rd Ste Aandb
Sacramento, CA 95820-6758

Mailing address

3838 Watt Ave Ste D-140
Sacramento, CA 95821-2663
Phone (916) 669-9038

Other practice location 1

3838 Watt Ave Ste D-140
Sacramento, CA 95821-2663
Phone (916) 669-9038

Other identifiers 1

IdentifierTypeStateIssuer
822125638MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EHR Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA51140CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jagdeep Garcha P.T PastSince Dec 26, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1164182010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 WATT AVE STE D-140",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212663",
            "telephone_number": "916-669-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 FRUITRIDGE RD STE AANDB",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958206758",
            "telephone_number": "916-669-9038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3838 Watt Ave Ste D-140",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958212663",
            "country_code": "US",
            "telephone_number": "916-669-9038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ISAAC",
        "middle_name": "EMILIO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PTA51140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822125638",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "endpointDescription": "Secure messaging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "webpt",
            "address_1": "8031 Fruitridge Rd Ste Aandb",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958206758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.