Individual provider Active NPI

Tani Maria Martinez, APRN

  • Family Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1174296636
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354031 Issued in NY
Practice address
95 E 13TH PL
Broomfield, CO 80020-1211
Phone
(786) 399-8998
NPI assigned
Jul 29, 2021
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.1000079-NP CO
Family Nurse Practitioner 363LF0000X APRN11011507 FL
Family Nurse Practitioner 363LF0000X 354031 NY Primary

Addresses

Primary practice location

95 E 13TH PL
Broomfield, CO 80020-1211

Mailing address

95 E 13TH PL
Broomfield, CO 80020-1211
Phone (786) 399-8998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250906000558 CO Practitioner - Nurse Practitioner 6507368784 Reassigns benefits to 1 organization
I20251002000455 NY Practitioner - Nurse Practitioner 6507368784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elan Sleep LLCGroup PAC ID 8426587742, 20 clinicians
Suffolk Primary Health LLCGroup PAC ID 9436420510, 46 clinicians

Practice addresses (Care Compare)

1630 Dry Creek Dr
Longmont, CO 80503-6422
Phone (720) 279-9098

170 Old Country Rd
Riverhead, NY 11901-2198
Phone (631) 208-4460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.1000079-NPCOMDFamily Nurse Practitioner
APRN11011507FLMDFamily Nurse Practitioner
354031NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suffolk Primary Health, LLC CurrentSince Jan 1, 2026 Accepting new patients
Vantage Medical Associates PC CurrentSince Jul 17, 2025 Accepting new patients
Elan Sleep LLC CurrentSince May 22, 2025 Accepting new patients

Locations

4895 Riverbend Rd
Ste A
Boulder, CO 80301

1630 Dry Creek Dr
Longmont, CO 80503

1630 Dry Creek Dr
Ste 200
Longmont, CO 80503

9399 Crown Crest Blvd
Ste 350
Parker, CO 80138
Phone (303) 269-4188

5308 13th Ave
Ste 334
Brooklyn, NY 11219

1612 Central Ave
Ste 201
Far Rockaway, NY 11691
Phone (516) 792-1600

170 Old Country Rd
Riverhead, NY 11901
Phone (631) 208-4460

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFCJCD
  • Direct secure messaging: tani.calderon.1@31554.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1174296636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 E 13TH PL",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201211",
            "telephone_number": "786-399-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 E 13TH PL",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201211",
            "telephone_number": "786-399-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TANI",
        "middle_name": "MARIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.1000079-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011507",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.