Individual provider Active NPI

Misael Martinez

  • Addiction (Substance Use Disorder) Psychologist
  • Port Chester, NY
National Provider Identifier
1265072763
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Practice address
132 Pearl St
Port Chester, NY 10573-7614
Phone
(914) 393-2700
NPI assigned
Jan 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X Primary

Addresses

Primary practice location

132 Pearl St
Port Chester, NY 10573-7614

Mailing address

8 Thomas Jefferson PL
Middletown, NY 10940-4511
Phone (845) 741-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109004362 NY Practitioner - Mental Health Counselor 6305297821 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012781NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital Yonkers Current Accepting new patients
St.Vincent' Hospital Westchester Psych CurrentSince Jan 1, 2024 Accepting new patients
St Josephs Hospital Yonkers CurrentSince Jan 1, 2024 Accepting new patients

Locations

275 North St
Harrison, NY 10528
Phone (914) 925-5211

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1265072763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 THOMAS JEFFERSON PL",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109404511",
            "telephone_number": "845-741-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 PEARL ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105737614",
            "telephone_number": "914-393-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MISAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.