Individual provider Active NPI

Martha Alvarez, PA

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1336799204
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
321109 Issued in LA
Practice address
725 N Ashley Ridge Loop Ste 100
Shreveport, LA 71106-7233
Phone
(318) 616-6011
NPI assigned
Sep 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 321109 LA Primary

Addresses

Primary practice location

725 N Ashley Ridge Loop Ste 100
Shreveport, LA 71106-7233

Mailing address

7600 Fern Ave Ste 700a
Shreveport, LA 71105-5673

Other practice location 1

7600 Fern Ave Ste 700A
Shreveport, LA 71105-5673
Phone (131) 861-6600

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20200128002962 LA Practitioner - Physician Assistant 0547696270 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1336799204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 FERN AVE STE 700A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N ASHLEY RIDGE LOOP STE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067233",
            "telephone_number": "318-616-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 Fern Ave Ste 700A",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055673",
            "country_code": "US",
            "telephone_number": "131-861-6600",
            "fax_number": "318-616-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "MARTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "321109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.