Individual provider Active NPI

Lisa Martinez, FNP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1467998039
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95005494 Issued in CA
Practice address
1500 21St St
Sacramento, CA 95811-5216
Phone
(916) 443-3299
NPI assigned
Jan 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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 NP95005494 CA Primary

Addresses

Primary practice location

1500 21St St
Sacramento, CA 95811-5216

Mailing address

1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299

Other practice location 1

3441 Marysville Blvd
Sacramento, CA 95838-4512
Phone (916) 397-5362

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
I20170807000314 CA Practitioner - Nurse Practitioner 9537430798

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95005494CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lisa.martinez.p1@direct.wellspacehealth.nextgenshare.com
  • Direct secure messaging: lmartinez782639@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1467998039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-443-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-443-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3441 Marysville Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958384512",
            "country_code": "US",
            "telephone_number": "916-397-5362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95005494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.