Individual provider Active NPI

Jessica A Martinez, PA-C

  • Medical Physician Assistant
  • Annandale, VA
National Provider Identifier
1609984400
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110002345 Issued in VA
Practice address
7432 Little River Tpke
Annandale, VA 22003-3013
Phone
(703) 658-7060
Fax
(703) 658-3150
NPI assigned
Aug 29, 2006
Last updated
Dec 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002345 VA Primary

Addresses

Primary practice location

7432 Little River Tpke
Annandale, VA 22003-3013

Mailing address

7432 Little River Tpke
Annandale, VA 22003-3013
Phone (703) 658-7060

Other practice location 1

3085 Nutley St
Fairfax, VA 22031-1931
Phone (703) 281-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002345VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Center LTD Past Accepting new patients
H Curtiss Merrick MD PA Past Accepting new patients
Pratt Medical Center LTD Past Accepting new patients
Homer Curtiss Merrick III MD Dba H Curtiss Merrick MD Past Accepting new patients

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, 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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1609984400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 LITTLE RIVER TPKE",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033013",
            "telephone_number": "703-658-7060",
            "fax_number": "703-658-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7432 LITTLE RIVER TPKE",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033013",
            "telephone_number": "703-658-7060",
            "fax_number": "703-658-3150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3085 Nutley St",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220311931",
            "country_code": "US",
            "telephone_number": "703-281-7771",
            "fax_number": "803-281-6713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

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