Active NPI
Kevin Martinez
- Social Worker
- Astoria, NY
National Provider Identifier
1205489614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 0998981
- Practice address
- 2509 Broadway
Astoria, NY 11106-3413 - Phone
- (718) 728-8476
- Fax
- (718) 204-7570
- NPI assigned
- Jul 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 0998981 | NY | Primary |
Addresses
Primary practice location
2509 Broadway
Astoria, NY 11106-3413
Mailing address
2509 Broadway
Astoria, NY 11106-3413
Phone (718) 728-8476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0998981 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | QSAC | Direct | QSAC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0998981 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1205489614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2509 BROADWAY",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111063413",
"telephone_number": "718-728-8476",
"fax_number": "718-204-7570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2509 BROADWAY",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111063413",
"telephone_number": "718-728-8476",
"fax_number": "718-204-7570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-24",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "0998981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0998981",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "QSAC",
"affiliation": "Y",
"affiliationName": "QSAC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "253 W 35th St Fl 16",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100011907",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.