Alfonso Martinez, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY3117 Issued in GA

Practice address

6000 Shakerag HL
Suite 216
Peachtree City, GA 30269-6523

Phone

(770) 632-1088

Fax

(770) 632-2088

NPI assigned

Nov 29, 2005

Sex

Male

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 GA

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Neuropsychology Center, LLCGroup PAC ID 1951487941, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• The Neuropsychology Center, LLC

  • Clinical Neuropsychologist
  • Peachtree City, GA
  • NPI 1568644995
  Medicare reassignment Care Compare group NPD Authorized official
• Center for Psychology, PA

  • Clinical Neuropsychologist
  • Fort Myers, FL
  • NPI 1952309296
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1316920952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MOUNT VERNON TRCE",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692641",
            "telephone_number": "770-629-4575",
            "fax_number": "770-629-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 SHAKERAG HL",
            "address_2": "SUITE 216",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696523",
            "telephone_number": "770-632-1088",
            "fax_number": "770-632-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5814",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY3117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry K Marcum, DMD
• Mark Lynn O.D. & Associates, P.C.
• Kevin Dwain Marler, M.D.
• Joshua Adam Martin, PA-C
• Stephanie Martin
• Marvelously Adorned, LLC
• Sydney Mason Weaver, ARNP
• Amanda Masters, MA
• Lauren Masters, PT, DPT
• Teressa Mathurin, LPC

• Clinical Neuropsychologist in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.