Individual provider Active NPI

Austin Martinez, DC

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1518626407
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
36171 Issued in CA
Practice address
830 2ND St Ste B
Santa Rosa, CA 95404-4620
Phone
(707) 494-2501
NPI assigned
Dec 8, 2021
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 36171 CA Primary

Addresses

Primary practice location

830 2ND St Ste B
Santa Rosa, CA 95404-4620

Mailing address

4561 Fable CT
Santa Rosa, CA 95404-6253
Phone (707) 494-2501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220321000717 CA Practitioner - Chiropractic 1254725625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

830 2ND St
Suite B
Santa Rosa, CA 95404-4620
Phone (707) 544-5338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Martinez Chiropractic, Inc Chiropractor CurrentSince Jan 18, 2022 Accepting new patients

Locations

830 2nd St
Ste B
Santa Rosa, CA 95404
Phone (707) 494-2501

Organizations & group practices 1

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1518626407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4561 FABLE CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046253",
            "telephone_number": "707-494-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 2ND ST STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044620",
            "telephone_number": "707-494-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "36171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.