Individual provider Active NPI

Juan Adrian Martinez, PT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1508345943
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
6330 Riverside Plaza LN NW Ste 150
Albuquerque, NM 87120-1803
Phone
(505) 312-7930
Fax
(505) 717-2818
NPI assigned
Aug 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

6330 Riverside Plaza LN NW Ste 150
Albuquerque, NM 87120-1803

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180906001091 NM Practitioner - Physical Therapist in Private Practice 9335499771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Physical Therapy and Wellness LLCGroup PAC ID 9032427513, 50 clinicians

Practice addresses (Care Compare)

7849 Tramway Blvd NE
Suite a
Albuquerque, NM 87122-2529
Phone (505) 821-3831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Dec 1, 2020 Accepting new patients
Physical Therapy at Dawn, LLC Physical Therapist CurrentSince Aug 13, 2018 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

6330 Riverside Plaza Ln NW
Ste 303
Albuquerque, NM 87120
Phone (505) 312-7930

6330 Riverside Plaza Ln NW
Albuquerque, NM 87120
Phone (505) 312-7930

7849 Tramway Blvd NE
Ste A
Albuquerque, NM 87122
Phone (505) 821-3831

6330 Riverside Plaza Ln NW
Ste 150
Albuquerque, NM 87120
Phone (505) 312-7930

240 S Camino del Pueblo
Ste G
Bernalillo, NM 87004
Phone (505) 373-2836

Organizations & group practices 2

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1508345943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 RIVERSIDE PLAZA LN NW STE 150",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201803",
            "telephone_number": "505-312-7930",
            "fax_number": "505-717-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JUAN",
        "middle_name": "ADRIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.