Individual provider Active NPI

Paul Howard Martines Jr., MPT

  • Physical Therapist
  • Madera, CA
National Provider Identifier
1386632958
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23974 Issued in CA
Practice address
1653 N Schnoor Ave Ste 107
Madera, CA 93637-3613
Phone
(559) 831-2050
Fax
(559) 660-5341
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23974 CA Primary

Addresses

Primary practice location

1653 N Schnoor Ave Ste 107
Madera, CA 93637-3613

Mailing address

701 W Center Ave
Visalia, CA 93291-6015
Phone (559) 713-6806

Other identifiers 3

IdentifierTypeStateIssuer
607749100OtherCAUS DOL
0PT239740OtherCABLUE SHIELD
P00193757OtherCARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208000914 CA Practitioner - Physical Therapist in Private Practice 4385600592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

323 N 11TH Ave
Suite 107
Hanford, CA 93230-4511
Phone (559) 772-8304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23974CAMDClinical Ethicist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Nov 12, 2019 Accepting new patients
Precision Rehabilitation & Orthopedic Physical Therapy Inc Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Precision Rehabilitation & Orthopedic Physical Therapy Inc Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients

Locations

4080 N Cedar Ave
Fresno, CA 93726
Phone (559) 222-7497

323 N 11th Ave
Ste 107
Hanford, CA 93230
Phone (559) 713-6806

1653 N Schnoor Ave
Ste 107
Madera, CA 93637
Phone (559) 831-2050

1870 S Central St
Visalia, CA 93277
Phone (559) 636-1200

701 W Center Ave
Visalia, CA 93291

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1386632958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916015",
            "telephone_number": "559-713-6806",
            "fax_number": "559-713-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 N SCHNOOR AVE STE 107",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936373613",
            "telephone_number": "559-831-2050",
            "fax_number": "559-660-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINES",
        "first_name": "PAUL",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "23974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DOL",
            "identifier": "607749100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0PT239740",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00193757",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.