Individual provider Active NPI

Jeffrey Lee Martz, PA-C

  • Medical Physician Assistant
  • Keller, TX
National Provider Identifier
1376013771
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA12493 Issued in TX
Practice address
808 Keller Pkwy
Keller, TX 76248-2405
Phone
(817) 431-2573
Fax
(817) 379-6881
NPI assigned
Nov 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA12493 TX Primary

Addresses

Primary practice location

808 Keller Pkwy
Keller, TX 76248-2405

Mailing address

808 Keller Pkwy
Keller, TX 76248-2405
Phone (817) 431-2573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190116000870 TX Practitioner - Physician Assistant 2961748769 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bill Burke, DO a Professional Association CurrentSince Oct 1, 2023 Accepting new patients

Locations

808 Keller Pkwy
Keller, TX 76248
Phone (817) 431-2573

Interoperability endpoints

  • Direct secure messaging: jeff.martz.1@28296.direct.athenahealth.com

Organizations & group practices 3

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": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1376013771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573",
            "fax_number": "817-379-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573",
            "fax_number": "817-379-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTZ",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-28",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA12493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.