Individual provider Active NPI

James John Martineau, RN, MSN, FNP, NP-C

  • Nurse Practitioner
  • Princeton, MN
National Provider Identifier
1205927084
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R 143375-7 Issued in MN
Practice address
1100 7TH Ave S
Express Clinic
Princeton, MN 55371-4555
Phone
(763) 389-5207
Fax
(763) 389-4138
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R 143375-7 MN Primary

Addresses

Primary practice location

1100 7TH Ave S
Express Clinic
Princeton, MN 55371-4555

Mailing address

25162 134TH St NW
Zimmerman, MN 55398-2103
Phone (763) 360-7070

Other identifiers 1

IdentifierTypeStateIssuer
41-1952112MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20061116000169 MN Practitioner - Nurse Practitioner 8921006487 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Kingdom Pediatrics LLCGroup PAC ID 7315266806, 19 clinicians

Practice addresses (Care Compare)

6452 City W Pkwy
Eden Prairie, MN 55344-3245
Phone (952) 999-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1933MNMDMarriage & Family Therapist
R 143375-7MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Feb 27, 2018 Accepting new patients
New Kingdom Pediatrics LLC CurrentSince Sep 1, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Feb 11, 2018 Accepting new patients
Fairview Express Care CurrentSince Feb 27, 2018 Accepting new patients
Fairview Express Care CurrentSince Sep 1, 2008 Accepting new patients
Fairview Clinics CurrentSince Feb 11, 2018 Accepting new patients

Locations

10904 57th St NE
Ste 106
Albertville, MN 55301
Phone (763) 497-0733

10904 Baltimore St NE
Blaine, MN 55449

150 E Travelers Trl
Ste D
Burnsville, MN 55337
Phone (952) 894-1400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6452 City West Pkwy
Eden Prairie, MN 55344
Phone (952) 999-0333

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

38500 Tanger Dr
Ste 108
North Branch, MN 55056

5366 386th St NE
North Branch, MN 55056
Phone (651) 674-6800

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

1100 7th Ave S
Princeton, MN 55371
Phone (763) 241-6803

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHFEDD/Endpoint/AHFEDD

Organizations & group practices 10

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1205927084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25162 134TH ST NW",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553982103",
            "telephone_number": "763-360-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 7TH AVE S",
            "address_2": "EXPRESS CLINIC",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553714555",
            "telephone_number": "763-389-5207",
            "fax_number": "763-389-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEAU",
        "first_name": "JAMES",
        "middle_name": "JOHN",
        "credential": "RN, MSN, FNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R 143375-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41-1952112",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, MN

Sources for this page

Verify at the official NPI Registry.