Individual provider Active NPI

Gilbert Martinez, PH.D.

  • Clinical Neuropsychologist
  • San Antonio, TX
National Provider Identifier
1407971138
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
30743 Issued in TX
Practice address
4242 Medical Dr
Suite 6250
San Antonio, TX 78229-5640
Phone
(210) 614-3011
Fax
(210) 615-6906
NPI assigned
Mar 20, 2007
Last updated
May 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 30743 TX Primary

Addresses

Primary practice location

4242 Medical Dr
Suite 6250
San Antonio, TX 78229-5640

Mailing address

16014 Via Shavano
San Antonio, TX 78249-2364
Phone (210) 614-3011

Other identifiers 2

IdentifierTypeStateIssuer
0009DGOtherTXBLUE CROSS BLUE SHIELD
030241601MedicaidTX

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000446 TX Practitioner - Clinical Psychologist 8123200524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16014 Via Shavano
San Antonio, TX 78249-2364
Phone (210) 614-3011

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Neuropsychological Associates PLLC Clinical Neuropsychologist CurrentSince Sep 30, 2010 Accepting new patients
South Texas Neurobehavioral Group LLC Clinical Neuropsychologist CurrentSince May 25, 2012 Accepting new patients
Nikhil Dhawan MD PLLC Past Accepting new patients
San Marcos Neurology Associates PastSince Nov 1, 1998 Accepting new patients

Locations

16014 Via Shavano
San Antonio, TX 78249
Phone (210) 612-1135

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1407971138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16014 VIA SHAVANO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492364",
            "telephone_number": "210-614-3011",
            "fax_number": "210-615-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR",
            "address_2": "SUITE 6250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295640",
            "telephone_number": "210-614-3011",
            "fax_number": "210-615-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "GILBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "30743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0009DG",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030241601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.