Active NPI
Jennifer Martin, PT
- Orthopedic Physical Therapist
- Fresno, CA
National Provider Identifier
1235238148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT17168
- Practice address
- 7405 N Cedar Ave
103
Fresno, CA 93720-3838 - Phone
- (559) 261-4100
- Fax
- (559) 261-4101
- NPI assigned
- Sep 21, 2006
- Last updated
- Sep 30, 2011
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT17168 | CA | Primary |
Addresses
Primary practice location
7405 N Cedar Ave
103
Fresno, CA 93720-3838
Mailing address
7405 N Cedar Ave
103
Fresno, CA 93720-3838
Phone (559) 261-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00084784 | Other | CA | MEDICARE RAILROAD IND. # |
| DA6172 | Other | CA | MEDICARE RAILROAD GROUP # |
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 |
|---|---|---|---|
| PT17168 | CA | MD | Orthopedic Physical Therapist |
| 17168 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimal Rehab Physical Therapy Inc. | Orthopedic | Past | Accepting new patients |
Organizations & group practices 1
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 Optimal Rehab Physical Therapy
- Orthopedic Physical Therapist
- Fresno, CA
- NPI 1942211669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317340800000",
"number": "1235238148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7405 N CEDAR AVE",
"address_2": "103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203838",
"telephone_number": "559-261-4100",
"fax_number": "559-261-4101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7405 N CEDAR AVE",
"address_2": "103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203838",
"telephone_number": "559-261-4100",
"fax_number": "559-261-4101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JENNIFER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2011-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT17168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD IND. #",
"identifier": "P00084784",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD GROUP #",
"identifier": "DA6172",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.