Organization Active NPI

Jesus a Martinez MD PC

  • General Practice Physician
  • Dearborn, MI
National Provider Identifier
1598989238
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
JM031056 Issued in MI
Legal business name
JESUS A MARTINEZ MD PC
Practice address
2012 Monroe Blvd Suite 104
Dearborn, MI 48124
Phone
(313) 359-0222
NPI assigned
Apr 12, 2007
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Jesus Martinez, MD
Title
General Practice
Phone
(313) 359-0222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X JM031056 MI Primary

Addresses

Primary practice location

2012 Monroe Blvd Suite 104
Dearborn, MI 48124

Mailing address

2012 Monroe Blvd Suite 104
Dearborn, MI 48124
Phone (313) 359-0222

Other identifiers 1

IdentifierTypeStateIssuer
4241325MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1598989238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 MONROE BLVD SUITE 104",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-359-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 MONROE BLVD SUITE 104",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-359-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS A MARTINEZ MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "GENERAL PRACTICE",
        "authorized_official_telephone_number": "313-359-0222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "JM031056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4241325",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.