Individual provider Active NPI

Omar Martinez-Quinones, LSA

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1164616298
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
10039 Bissonnet St Ste 250
Houston, TX 77036-7852
Phone
(713) 779-9800
Fax
(713) 779-9862
NPI assigned
Aug 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

10039 Bissonnet St Ste 250
Houston, TX 77036-7852

Mailing address

709 Mills LN
Friendswood, TX 77546-4746
Phone (713) 562-0938

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

Practice roles

OrganizationSpecialtyStatusNew patients
Omkm Surgical CurrentSince Nov 13, 2022 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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1164616298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 MILLS LN",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775464746",
            "telephone_number": "713-562-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10039 BISSONNET ST STE 250",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770367852",
            "telephone_number": "713-779-9800",
            "fax_number": "713-779-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-QUINONES",
        "first_name": "OMAR",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.