Individual provider Active NPI

John Joseph Martinez, MS, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1508531831
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone
(612) 871-1454
Fax
(612) 871-1505
NPI assigned
Aug 10, 2021
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Mailing address

1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone (612) 871-1454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250224001513 MN Practitioner - Mental Health Counselor 2769902527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1370 Mendota Heights Rd
Mendota Heights, MN 55120-1128

13890 McKenna Rd NW
Prior Lake, MN 55379-7537

1900 Silver Lake NWRD
Suite 110
New Brighton, MN 55112-1789

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4678MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Apr 13, 2026 Accepting new patients
Washburn Center for Children PastSince Nov 17, 2024 Accepting new patients
Phia T Xiong & Jeff D Spencer Foundation PastSince May 1, 2022 Accepting new patients

Locations

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 252-4830

2125 E Hennepin Ave
Ste 100
Minneapolis, MN 55413
Phone (612) 217-2055

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 307-5148

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1508531831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "MS, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.