Individual provider Active NPI

Dianelys Martinez

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1508496340
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN11010952 Issued in FL
Practice address
9060 NW 190TH St
Hialeah, FL 33018-6266
Phone
(305) 989-5710
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X APN0000026459 TN
Family Medicine Physician 207Q00000X APRN11010952 FL Primary

Addresses

Primary practice location

9060 NW 190TH St
Hialeah, FL 33018-6266

Mailing address

9060 NW 190TH St
Hialeah, FL 33018-6266
Phone (305) 989-5710

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211208000981 FL Practitioner - Nurse Practitioner 5991195851 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000026459TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Tankersley Clinic, PLLC PastSince Jan 1, 2020 Accepting new patients

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": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1508496340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9060 NW 190TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186266",
            "telephone_number": "305-989-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9060 NW 190TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186266",
            "telephone_number": "305-989-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "DIANELYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "APN0000026459",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11010952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.