Individual provider Active NPI

Shadae April Martinez, FNP-C

  • Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1558028134
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1057521 Issued in TX
Practice address
121 E Redd Rd
El Paso, TX 79932-1981
Phone
(915) 584-8884
NPI assigned
Nov 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1057521 TX
Nurse Practitioner 363L00000X 1057521 TX Primary

Addresses

Primary practice location

121 E Redd Rd
El Paso, TX 79932-1981

Mailing address

14917 Long Shadow Ave
El Paso, TX 79938-3193
Phone (210) 430-8326

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
I20230131000739 TX Practitioner - Nurse Practitioner 5698146686 Reassigns benefits to 2 organizations

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
Upper Valley Urgent Care CenterGroup PAC ID 8426055054, 5 clinicians

Practice addresses (Care Compare)

121 E Redd Rd
El Paso, TX 79932-1981
Phone (915) 584-8882

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1057521TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Valley Wellness Clinic, PA Current Accepting new patients
Upper Valley Urgent Care Center CurrentSince Oct 21, 2023 Accepting new patients
Emergency Services of Texas PA Nurse Practitioner CurrentSince Feb 1, 2023 Accepting new patients

Locations

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

10301 Gateway Blvd W
El Paso, TX 79925
Phone (915) 543-2424

121 E Redd Rd
El Paso, TX 79932
Phone (915) 584-8822

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1558028134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14917 LONG SHADOW AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799383193",
            "telephone_number": "210-430-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E REDD RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799321981",
            "telephone_number": "915-584-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "SHADAE",
        "middle_name": "APRIL",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1057521",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1057521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.