Andrei Martin

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5696H Issued in AZ

Practice address

6338 W Port Royale LN
Glendale, AZ 85306-3260

Phone

(623) 487-0488

Fax

(623) 487-0488

NPI assigned

Jul 2, 2018

Last updated

Jul 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sunrise Adult Care Home #2

  • Assisted Living Facility
  • Glendale, AZ
  • NPI 1528554615
  NPD (past) Authorized official

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1316433493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6338 W PORT ROYALE LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063260",
            "telephone_number": "623-487-0488",
            "fax_number": "623-487-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6338 W PORT ROYALE LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063260",
            "telephone_number": "623-487-0488",
            "fax_number": "623-487-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANDREI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL5696H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023450",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea M Martell, MPT
• Joanne Marie Martelli, PMHNP
• Erin June Martens, MD
• Martin C Gage PC (Gage Chiropractic Health Center)
• Kerry Jean Martin-Doehring, MA, LMFT, IMH-E
• Camelia Martin, DNP, FNP-BC
• Christina Michelle Martin, D.O.
• Denise Martin
• Heidi Elizabeth Martin, MC, LPC
• Kelly Martin, COTA

• Assisted Living Facility in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.