Individual provider Active NPI

Namyr Antonio Martinez, MD, PHD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1356742563
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD046140 Issued in DC
Practice address
Barrio Monacillos
San Juan, PR 00935-2648
Phone
(787) 777-3535
NPI assigned
Sep 7, 2014
Last updated
Jul 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD046140 DC Primary

Addresses

Primary practice location

Barrio Monacillos
San Juan, PR 00935-2648

Mailing address

14 Calle Amapola # 904
Carolina, PR 00979

Other practice location 1

111 Michigan Ave NW
Childrens National Medical Center
Washington, DC 20010
Phone (202) 476-3277

Other practice location 2

4601 Ironbound Rd
Williamsburg, VA 23188-2648
Phone (757) 920-3616

Other identifiers 3

IdentifierTypeStateIssuer
I20180530000343OtherDCMEDICARE
577002500MedicaidMD
024355883MedicaidDC

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MD046140DCMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1410048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1356742563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CALLE AMAPOLA # 904",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "fax_number": "888-367-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BARRIO MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009352648",
            "telephone_number": "787-777-3535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Michigan Ave NW",
            "address_2": "CHILDRENS NATIONAL MEDICAL CENTER",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20010",
            "country_code": "US",
            "telephone_number": "202-476-3277",
            "fax_number": "888-367-1898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4601 Ironbound Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231882648",
            "country_code": "US",
            "telephone_number": "757-920-3616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "NAMYR",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DC",
            "license": "MD046140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "I20180530000343",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "577002500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024355883",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.