Individual provider Active NPI

Jacob Martinez, DO

  • Family Medicine Physician
  • Bethel Park, PA
National Provider Identifier
1235690306
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS022126 Issued in PA
Practice address
2000 Oxford Dr Ste 560
Bethel Park, PA 15102-1892
Phone
(412) 831-1522
Fax
(412) 835-2746
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS022126 PA Primary

Addresses

Primary practice location

2000 Oxford Dr Ste 560
Bethel Park, PA 15102-1892

Mailing address

701 Technology Dr Ste 150
Canonsburg, PA 15317-9531
Phone (412) 531-2902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715002531 PA Practitioner - Family Practice 7012243710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Preferred Primary Care Physicians, Inc.Group PAC ID 8527967256, 88 clinicians

Practice addresses (Care Compare)

2000 Oxford Dr
Suite 560
Bethel Park, PA 15102-1892
Phone (412) 831-1522

Hospital & facility affiliations

  • St Clair Hospital Hospital, Pittsburgh, PA, CCN 390228
  • Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS022126PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Primary Care Physicians, Inc. Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Preferred Primary Care Physicians, Inc. Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Preferred Primary Care Physicians Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Preferred Primary Care Physicians Family Medicine PastSince Mar 26, 2023 Accepting new patients

Locations

2000 Oxford Dr
Ste 220
Bethel Park, PA 15102
Phone (412) 831-1522

2000 Oxford Dr
Ste 560
Bethel Park, PA 15102
Phone (412) 831-1522

701 Technology Dr
Ste 150
Canonsburg, PA 15317
Phone (412) 531-2902

2375 Greentree Rd
Carnegie, PA 15106
Phone (412) 276-1560

1050 Bower Hill Rd
Ste 202
Pittsburgh, PA 15243
Phone (412) 572-6122

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1235690306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 TECHNOLOGY DR STE 150",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179531",
            "telephone_number": "412-531-2902",
            "fax_number": "412-531-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR STE 560",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021892",
            "telephone_number": "412-831-1522",
            "fax_number": "412-835-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS022126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel Park, PA

Sources for this page

Verify at the official NPI Registry.