Individual provider Active NPI

Wanda I Martinez, NP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1447540885
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310949-01 Issued in NY
Practice address
318 Knickerbocker Ave
Brooklyn, NY 11237-3888
Phone
(718) 765-6056
Fax
(347) 803-1874
NPI assigned
Apr 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F310949-01 NY Primary

Addresses

Primary practice location

318 Knickerbocker Ave
Brooklyn, NY 11237-3888

Mailing address

PO Box 740020
Atlanta, GA 30374-0020
Phone (312) 733-9730

Other practice location 1

557 Knickerbocker Ave
Apt4G
Brooklyn, NY 11221-4749
Phone (347) 715-7421

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F310949-01NYMDAdult Health Nurse Practitioner

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1447540885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740020",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740020",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373888",
            "telephone_number": "718-765-6056",
            "fax_number": "347-803-1874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "557 Knickerbocker Ave",
            "address_2": "Apt4G",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112214749",
            "country_code": "US",
            "telephone_number": "347-715-7421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "WANDA",
        "middle_name": "I",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310949-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.