Individual provider Active NPI

Raquel Q Martinez, PA-C

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1417589003
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10615 Jeffreys St
Henderson, NV 89052-4194
Phone
(702) 463-4788
NPI assigned
Feb 11, 2020
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

10615 Jeffreys St
Henderson, NV 89052-4194

Mailing address

1000 American Pacific Dr Apt 2113
Henderson, NV 89074-8017
Phone (702) 858-1357

Other practice location 1

870 Seven Hills Dr
Henderson, NV 89052-4377
Phone (702) 463-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20231008000116 NV Practitioner - Physician Assistant 8921453119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vincent D Ho Psychiatry PLLCGroup PAC ID 2062642085, 7 clinicians

Practice addresses (Care Compare)

870 Seven Hills Dr
Suite 203
Henderson, NV 89052-4379
Phone (702) 374-4322

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raquel Martinez PastSince Apr 17, 2020 Accepting new patients

Organizations & group practices 2

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1417589003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 AMERICAN PACIFIC DR APT 2113",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748017",
            "telephone_number": "702-858-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 JEFFREYS ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524194",
            "telephone_number": "702-463-4788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "870 Seven Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524377",
            "country_code": "US",
            "telephone_number": "702-463-4788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "RAQUEL",
        "middle_name": "Q",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.