Active NPI
Namyr Antonio Martinez, MD, PHD
- General Practice Physician
- San Juan, PR
National Provider Identifier
1356742563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- MD046140
- Practice address
- Barrio Monacillos
San Juan, PR 00935-2648 - Phone
- (787) 777-3535
- NPI assigned
- Sep 7, 2014
- Last updated
- Jul 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I20180530000343 | Other | DC | MEDICARE |
| 577002500 | Medicaid | MD | |
| 024355883 | Medicaid | DC |
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.
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD046140 | DC | MD | General 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.