Individual provider Active NPI

Angela M Martin, PT, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1194383778
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1318549 Issued in TX
Practice address
2130 NE Loop 410 Ste 212
San Antonio, TX 78217-4662
Phone
(210) 656-5848
Fax
(210) 656-5847
NPI assigned
May 30, 2019
Last updated
May 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1318549 TX Primary

Addresses

Primary practice location

2130 NE Loop 410 Ste 212
San Antonio, TX 78217-4662

Mailing address

415 Embassy Oaks Ste 202
San Antonio, TX 78216-2042
Phone (210) 490-4738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624001441 TX Practitioner - Physical Therapist in Private Practice 8224362306 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Rehabilitation Specialists Inc Multi-Specialty CurrentSince Jun 3, 2019 Accepting new patients
Liberty Rehabilitation Specialists Inc Multi-Specialty CurrentSince Jun 3, 2019 Accepting new patients

Locations

17006 San Pedro Ave
San Antonio, TX 78232
Phone (210) 490-4738

2130 NE Loop 410
Ste 212
San Antonio, TX 78217
Phone (210) 656-5848

415 Embassy Oaks
Ste 202
San Antonio, TX 78216
Phone (210) 490-4738

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1194383778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 EMBASSY OAKS STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162042",
            "telephone_number": "210-490-4738",
            "fax_number": "210-490-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 NE LOOP 410 STE 212",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782174662",
            "telephone_number": "210-656-5848",
            "fax_number": "210-656-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1318549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.