Individual provider Active NPI

Alexis Marie Martinez, PA-C

  • Physician Assistant
  • Moreno Valley, CA
National Provider Identifier
1174233936
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66548 Issued in CA
Practice address
26600 Cactus Ave Ste 300
Moreno Valley, CA 92555-3901
Phone
(951) 850-2525
NPI assigned
Dec 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA66548 CA Primary

Addresses

Primary practice location

26600 Cactus Ave Ste 300
Moreno Valley, CA 92555-3901

Mailing address

PO Box 3721
Riverside, CA 92519-3721
Phone (951) 850-2525

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
I20250729002454 CA Practitioner - Physician Assistant 2961919402 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66548CAMDClinical Social Worker
PA66548CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Aug 12, 2025 Accepting new patients
County of Riverside CurrentSince Jul 1, 2025 Accepting new patients
County of Riverside CurrentSince Jul 1, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Interoperability endpoints

  • Direct secure messaging: amartinez1259380@direct.llu.edu

Organizations & group practices 5

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": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1174233936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3721",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925193721",
            "telephone_number": "951-850-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26600 CACTUS AVE STE 300",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553901",
            "telephone_number": "951-850-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.