Individual provider Active NPI

Roberto Martinez Ledesma, PA

  • Physician Assistant
  • Palm Springs, FL
National Provider Identifier
1407554702
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PACN43 Issued in FL
Practice address
3145 S Congress Ave Ste B
Palm Springs, FL 33461-2553
Phone
(561) 360-2034
Fax
(561) 360-2650
NPI assigned
Feb 16, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PACN43 FL Primary
Physician Assistant 363A00000X 1563 PR

Addresses

Primary practice location

3145 S Congress Ave Ste B
Palm Springs, FL 33461-2553

Mailing address

3145 S Congress Ave Ste B
Palm Springs, FL 33461-2553
Phone (561) 360-2034

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PACN43FLMDPhysician Assistant
1563PRMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Medical Center, PA #4 Past Accepting new patients

Organizations & group practices 1

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1407554702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 S CONGRESS AVE STE B",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612553",
            "telephone_number": "561-360-2034",
            "fax_number": "561-360-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 S CONGRESS AVE STE B",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612553",
            "telephone_number": "561-360-2034",
            "fax_number": "561-360-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ LEDESMA",
        "first_name": "ROBERTO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PACN43",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "1563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.