Active NPI
Anne F Martinez, PA
- Physician Assistant
- Georgetown, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA04096
- Practice address
- 908 Rockmoor Dr
Georgetown, TX 78628-8966 - Phone
- (512) 868-0901
- Fax
- (512) 868-1527
- NPI assigned
- Nov 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA04096 | TX | Primary |
Addresses
Primary practice location
908 Rockmoor Dr
Georgetown, TX 78628-8966
Mailing address
908 Rockmoor Dr
Georgetown, TX 78628-8966
Phone (512) 868-0901
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA04096 | Other | TX | PHYSICIAN'S ASST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2301 N Lake Dr
Milwaukee, WI 53211-4508
2311 N Prospect Ave
Milwaukee, WI 53211-4445
Phone (414) 319-3000
2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000
801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA04096 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia St. Mary's Hospital Milwaukee Inc | Current | Accepting new patients | |
| Columbia St. Mary's Hospital Milwaukee, Inc | Current | Accepting new patients | |
| Columbia St. Mary's Hospital Milwaukee, Inc | Past | Accepting new patients |
Locations
2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000
2350 N Lake Dr
Ste 501
Milwaukee, WI 53211
Phone (414) 226-4020
801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600
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.
-
dba Ascension Columbia St Mary's Hospital Milwaukee
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
-
dba Ascension Columbia St Mary's Hospital Ozaukee
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
dba Ascension Columbia St Mary's Hospital Milwaukee
- Multi-Specialty Clinic/Center
- Mequon, WI
- NPI 1710928221
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension Columbia St Mary's Hospital Milwaukee Campus
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1871656082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205902368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "908 ROCKMOOR DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786288966",
"telephone_number": "512-868-0901",
"fax_number": "512-868-1527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 ROCKMOOR DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786288966",
"telephone_number": "512-868-0901",
"fax_number": "512-868-1527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "ANNE",
"middle_name": "F",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA04096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN'S ASST LICENSE",
"identifier": "PA04096",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.