Individual provider Active NPI

Brianna Martinez, PA-C

  • Physician Assistant
  • Victoria, TX
National Provider Identifier
1548633191
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10084 Issued in TX
Practice address
605 E San Antonio St Ste 520E
Victoria, TX 77901-6086
Phone
(361) 576-0633
Fax
(361) 576-0639
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X TX
Physician Assistant 363A00000X PA10084 TX Primary

Addresses

Primary practice location

605 E San Antonio St Ste 520E
Victoria, TX 77901-6086

Mailing address

605 E San Antonio St Ste 520E
Victoria, TX 77901-6086
Phone (361) 576-0633

Other identifiers 1

IdentifierTypeStateIssuer
PA10084OtherTXTEXAS PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151229000400 TX Practitioner - Physician Assistant 4486955929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1900 Pine St
Abilene, TX 79601-2432

Hospital & facility affiliations

  • Hendrick Medical Center Hospital, Abilene, TX, CCN 450229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Orthopedic Center PLLC CurrentSince Nov 15, 2015 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

6404 Nursery Dr
Ste 202
Victoria, TX 77904
Phone (361) 333-5321

605 E San Antonio St
Ste 520E
Victoria, TX 77901
Phone (361) 576-0633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDBEBD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1548633191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E SAN ANTONIO ST STE 520E",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016086",
            "telephone_number": "361-576-0633",
            "fax_number": "361-576-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E SAN ANTONIO ST STE 520E",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016086",
            "telephone_number": "361-576-0633",
            "fax_number": "361-576-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "BRIANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PERMIT",
            "identifier": "PA10084",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.