Individual provider Active NPI

Nathan Daniel Martinez, FNP

  • Family Nurse Practitioner
  • Casa Grande, AZ
National Provider Identifier
1508523929
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
264061 Issued in AZ
Practice address
1676 E McMurray Blvd Ste 1
Casa Grande, AZ 85122-4798
Phone
(520) 316-0688
NPI assigned
Nov 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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 264061 AZ Primary

Addresses

Primary practice location

1676 E McMurray Blvd Ste 1
Casa Grande, AZ 85122-4798

Mailing address

6310 W Victory Way
Florence, AZ 85132-7505
Phone (480) 298-9483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220112001928 AZ Practitioner - Nurse Practitioner 4082006564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

17900 N Porter Rd
Maricopa, AZ 85138-4228
Phone (520) 233-2500

3457 W White Mountain Blvd
Lakeside, AZ 85929-6007
Phone (928) 358-1515

680 E Deuce of Clubs
Show Low, AZ 85901-4829
Phone (928) 596-4580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
264061AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jul 15, 2025 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jul 15, 2025 Accepting new patients

Locations

3457 W White Mountain Blvd
Lakeside, AZ 85929
Phone (888) 264-2127

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

101 E State Highway 260
Ste G
Payson, AZ 85541
Phone (888) 264-2127

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

680 E Deuce of Clubs
Show Low, AZ 85901
Phone (888) 264-2127

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": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1508523929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 W VICTORY WAY",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851327505",
            "telephone_number": "480-298-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 E MCMURRAY BLVD STE 1",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224798",
            "telephone_number": "520-316-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "NATHAN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "264061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.