NPIMap

Individual provider Active NPI

Jesse S Martinez, LISW

  • Social Worker
  • Espanola, NM
National Provider Identifier
1306059522
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-3701 Issued in NM
Practice address
577 El Llano Rd
Espanola, NM 87532-2911
Phone
(505) 753-1656
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I-3701 NM Primary

Addresses

Primary practice location

577 El Llano Rd
Espanola, NM 87532-2911

Mailing address

577 El Llano Rd
Espanola, NM 87532-2911
Phone (505) 753-1656

Other names 1

  • Mr. Jesse S Martinez Other name

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

LicenseStateTypeSpecialty
I-3701NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Crisis Center of NNM 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306059522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 EL LLANO RD",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322911",
            "telephone_number": "505-753-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 EL LLANO RD",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322911",
            "telephone_number": "505-753-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JESSE",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I-3701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "MARTINEZ",
            "middle_name": "S",
            "prefix": "MR.",
            "credential": "LISW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Espanola, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.