Ethel De Jesus Martinez

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95008170 Issued in CA

Practice address

8902 Woodman Ave
Arleta, CA 91331-6401

Phone

(818) 830-7133

NPI assigned

Nov 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El Proyecto del Barrio IncGroup PAC ID 3476546227, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Azusa, CA
  • NPI 1770696023
  Medicare reassignment Care Compare group NPD
• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Arleta, CA
  • NPI 1083624423
  NPD
• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Northridge, CA
  • NPI 1093181448
  NPD

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306359294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8902 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913316401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8902 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913316401",
            "telephone_number": "818-830-7133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20800 Sherman Way",
            "address_purpose": "LOCATION",
            "city": "Winnetka",
            "state": "CA",
            "postal_code": "913062707",
            "country_code": "US",
            "telephone_number": "818-967-0148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20800 Sherman Way",
            "address_purpose": "LOCATION",
            "city": "Winnetka",
            "state": "CA",
            "postal_code": "913062707",
            "country_code": "US",
            "telephone_number": "818-967-0148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ETHEL",
        "middle_name": "DE JESUS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer V. Mansourian, OTR/L
• Manuel Deleon DDS a Dental Corporation
• Leander Enriquez Manzano, MD
• Judith Carole Marcus, PA
• Donneta Patrice Marshall, FNP
• Julie Martinez
• Masood Imanuel DMD a Dental Corporation
• John Matias, OTR/L
• Maxcare Comfort
• Maydads Medical Supply

• Family Nurse Practitioner in Arleta, CA
• Providers in Arleta, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.