Individual provider Active NPI

Edgar Martinez, MD

  • Dermatology Physician
  • Plano, TX
National Provider Identifier
1295314359
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
V7953 Issued in TX
Practice address
5030 Tennyson Pkwy Ste 100
Plano, TX 75024-3397
Phone
(972) 985-9003
Fax
(972) 985-1176
NPI assigned
Apr 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X V7953 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5030 Tennyson Pkwy Ste 100
Plano, TX 75024-3397

Mailing address

5030 Tennyson Pkwy Ste 100
Plano, TX 75024-3397
Phone (972) 985-9003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250724002082 TX Practitioner - Dermatology 6103226907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Southwestern Medical School at Dallas, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

5030 Tennyson Pkwy
Suite 100
Plano, TX 75024-3397
Phone (972) 985-9003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions274
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V7953TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Sep 1, 2025 Accepting new patients
Dermatology Associates Dermatology PastSince Sep 1, 2025 Accepting new patients

Locations

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

5030 Tennyson Pkwy
Ste 100
Plano, TX 75024
Phone (972) 945-3854

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: edgar.martinez.1@8363.direct.athenahealth.com
  • Direct secure messaging: edgar.martinez.2@8363.direct.athenahealth.com

Organizations & group practices 2

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1295314359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 TENNYSON PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243397",
            "telephone_number": "972-985-9003",
            "fax_number": "972-985-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 TENNYSON PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243397",
            "telephone_number": "972-985-9003",
            "fax_number": "972-985-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EDGAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V7953",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.