Individual provider Active NPI

Gerardo Jesus Martinez

  • Family Nurse Practitioner
  • Calexico, CA
National Provider Identifier
1194430165
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023262 Issued in CA
Practice address
223 W Cole Blvd
Calexico, CA 92231-9722
Phone
(760) 357-2020
NPI assigned
Jan 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023262 CA Primary

Addresses

Primary practice location

223 W Cole Blvd
Calexico, CA 92231-9722

Mailing address

2436 Earhart CT
Imperial, CA 92251-9006
Phone (760) 960-1704

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
I20230309002322 CA Practitioner - Nurse Practitioner 3678946779 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas de Salud del Pueblo, Inc CurrentSince Feb 13, 2023 Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Feb 13, 2023 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Clinicas de Salud del Pueblo, Inc. Past Accepting new patients

Locations

223 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-2020

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

Interoperability endpoints

  • Direct secure messaging: gerardo.martinez.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 4

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": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1194430165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 EARHART CT",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922519006",
            "telephone_number": "760-960-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W COLE BLVD",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922319722",
            "telephone_number": "760-357-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "GERARDO",
        "middle_name": "JESUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calexico, CA

Sources for this page

Verify at the official NPI Registry.