La Tisha Martinez, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

79563 Issued in NM

Practice address

3825 Eubank Blvd NE Ste a
Albuquerque, NM 87111-3590

Phone

(052) 928-5755

Fax

(505) 292-8409

NPI assigned

Jun 22, 2024

Last updated

Mar 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bella Vida Health Care and Medi SpaGroup PAC ID 6507092327, 14 clinicians

Family Medicine PCGroup PAC ID 0042407603, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bella Vida Health Care and Medi Spa

  • Health Service Clinic/Center
  • Los Lunas, NM
  • NPI 1568704237
  Medicare reassignment Care Compare group NPD
• Family Medicine PC

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1083802029
  Medicare reassignment Care Compare group NPD
• Spencer J Hardenbrook MD PC

  • Family Medicine Physician
  • Draper, UT
  • NPI 1073909594
  NPD

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1174367312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 CANYON VISTA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116621",
            "telephone_number": "505-400-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113590",
            "telephone_number": "052-928-5755",
            "fax_number": "505-292-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LA TISHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-22",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "79563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley P. Martinez, CFNP
• Kevin A Martinez
• Kimberly Nicole Martinez, APRN-CNP
• Kori Dawn Martinez, APRN-FNP
• Kylie Martinez
• Lauren Martinez
• Leroy C Martinez Jr.
• Lilia Ivonne Martinez, BSW
• Linda G Martinez, RN
• Linzi Martinez

• Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.