NPIMap

Individual provider Active NPI

Suzanne B Martin, PT

  • Physical Therapist
  • Palm Springs, CA
National Provider Identifier
1245319862
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292199 Issued in CA
Practice address
552 S Paseo Dorotea Ste 4
Palm Springs, CA 92264-1437
Phone
(760) 325-5950
Fax
(760) 325-5945
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT22727 FL
Physical Therapist 225100000X 1191167 TX
Physical Therapist 225100000X 292199 CA Primary

Addresses

Primary practice location

552 S Paseo Dorotea Ste 4
Palm Springs, CA 92264-1437

Mailing address

3760 Convoy St Ste 101
San Diego, CA 92111-3743
Phone (858) 264-1434

Other identifiers 2

IdentifierTypeStateIssuer
PT22727OtherFLSTATE LICENSE
TXB116253OtherTXPTAN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
292199CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist Past Accepting new patients
Well Body Clinic Inc Physical Therapist Past Accepting new patients
Body Owners Physical Therapy & Wellness Center, LLC Physical Therapist PastSince Nov 9, 2015 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1245319862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-264-1434",
            "fax_number": "858-751-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 S PASEO DOROTEA STE 4",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641437",
            "telephone_number": "760-325-5950",
            "fax_number": "760-325-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SUZANNE",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22727",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1191167",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT22727",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "TXB116253",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.