Individual provider Active NPI

Ivan Martinez

  • Family Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1467212357
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95028518 Issued in CA
Practice address
14550 Haynes St
Van Nuys, CA 91411-1613
Phone
(818) 650-6700
NPI assigned
Mar 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95028518 CA Primary

Addresses

Primary practice location

14550 Haynes St
Van Nuys, CA 91411-1613

Mailing address

14550 Haynes St
Van Nuys, CA 91411-1613
Phone (818) 650-6700

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240423000993 CA Practitioner - Nurse Practitioner 7315386406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

8001 Ventura Canyon Ave
Panorama City, CA 91402-6312
Phone (818) 375-2000

8033 Ventura Canyon Ave
Panorama City, CA 91402-6312
Phone (818) 375-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95028518CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Medical Center, Inc. Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 15, 2025 Accepting new patients
Southern California Medical Center, Inc. CurrentSince Mar 20, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 15, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Medical Center, Inc. Past Accepting new patients
Southern California Medical Center, Inc. Past Accepting new patients

Locations

12100 Valley Blvd
Ste 109A
El Monte, CA 91732
Phone (626) 575-7500

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

8825 Whittier Blvd
Pico Rivera, CA 90660
Phone (562) 699-3333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ivanfnp.martinez.p1@direct.scmedcenter.nextgenshare.com

Organizations & group practices 7

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1467212357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14550 HAYNES ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111613",
            "telephone_number": "818-650-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14550 HAYNES ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111613",
            "telephone_number": "818-650-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-19",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95028518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "14550 Haynes St",
            "city": "Van Nuys",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914111613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.