Individual provider Active NPI

Taylor Martinez, PSYD

  • Clinical Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1487420899
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12102 Issued in FL
Practice address
1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875
Phone
(985) 885-9500
Fax
(954) 885-9444
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY12102 FL Primary

Addresses

Primary practice location

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875

Mailing address

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875
Phone (985) 885-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231129001160 FL Practitioner - Clinical Psychologist 1355799560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transformative Healthcare Solutions IncGroup PAC ID 8921337973, 27 clinicians

Practice addresses (Care Compare)

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875
Phone (954) 885-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Florida PA Clinical CurrentSince Jun 19, 2024 Accepting new patients
Transformative Healthcare Solutions Inc Clinical CurrentSince Nov 27, 2023 Accepting new patients
Pro Performance Physical Therapy LLC PastSince Jun 26, 2019 Accepting new patients

Locations

2544 E Sunrise Blvd
Fort Lauderdale, FL 33304
Phone (954) 253-0853

1848 SE 1st Ave
Ft Lauderdale, FL 33316
Phone (954) 366-2700

Organizations & group practices 3

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1487420899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "985-885-9500",
            "fax_number": "954-885-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "985-885-9500",
            "fax_number": "954-885-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TAYLOR",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.