NPIMap

Individual provider Active NPI

Luis A Martinez, M.D.

  • Family Medicine Physician
  • Perham, MN
National Provider Identifier
1487634226
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45359 Issued in MN
Practice address
1000 Coney St W
Perham, MN 56573-2102
Phone
(218) 347-1200
NPI assigned
Jan 18, 2006
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 45359 MN
Family Medicine Physician 207Q00000X 45359 MN Primary

Addresses

Primary practice location

1000 Coney St W
Perham, MN 56573-2102

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435
Phone (952) 835-9880

Other identifiers 1

IdentifierTypeStateIssuer
514110900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmartinez17215144@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050804000311 MN Practitioner - Family PracticePractitioner - Emergency Medicine 8022047638 Reassigns benefits to 2 organizations
I20210504000933 MN Practitioner - Emergency Medicine 8022047638 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

265 Creek LN S
Jordan, MN 55352-1214
Phone (952) 428-1200

8170 Old Carriage CT
Suite 100
Shakopee, MN 55379-3164
Phone (952) 428-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45359MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essentia Health Moose Lake CurrentSince Jan 24, 2022 Accepting new patients
Essentia Health Moose Lake CurrentSince Jan 24, 2022 Accepting new patients
St Francis Regional Medical Center CurrentSince Jun 19, 2023 Accepting new patients
Pine Medical Center CurrentSince Jan 24, 2022 Accepting new patients
St. Francis Regional Medical Center CurrentSince Jun 19, 2023 Accepting new patients
Perham Hospital District Family Medicine Current Accepting new patients
Perham Hospital District CurrentSince Mar 22, 2021 Accepting new patients
County of Meeker Current Accepting new patients
CCM Health Current Accepting new patients
Pine Medical Center CurrentSince Jan 24, 2022 Accepting new patients
Perham Hospital District Current Accepting new patients
Perham Hospital District Emergency Medicine CurrentSince Mar 22, 2021 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Sibley Medical Center Past Accepting new patients
County of Meeker Past Accepting new patients
Madelia Health Past Accepting new patients
Luther Memorial Home Past Accepting new patients
North Ridge Skilled, LLC Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

105 Otter Dr
Ottertail, MN 56571
Phone (218) 367-6111

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

Interoperability endpoints

  • Direct secure messaging: lmartinez17215144@direct.sanfordhealth.org
  • Direct secure messaging: lmartinez424679@direct.centracare.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1487634226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Marketpointe Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "55435",
            "country_code": "US",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LUIS",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "45359",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "45359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514110900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmartinez17215144@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "4300 Marketpointe Dr Ste 100",
            "city": "Bloomington",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

Verify at the official NPI Registry.