Individual provider Active NPI

Marissa Marie Martinez, MS, RDN, LD

  • Registered Dietitian
  • San Antonio, TX
National Provider Identifier
1619432432
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86050978 Issued in TX
Practice address
646 S Flores St
San Antonio, TX 78204-1219
Phone
(855) 481-1149
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86050978 TX Primary

Addresses

Primary practice location

646 S Flores St
San Antonio, TX 78204-1219

Mailing address

646 S Flores St
San Antonio, TX 78204-1219
Phone (855) 481-1149

Other practice location 1

3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone (361) 694-4986 ext. 5656

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
Master of Science

State licenses

LicenseStateTypeSpecialty
86050978TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B Wellness Services Inc Dietitian, Registered CurrentSince Jan 30, 2024 Accepting new patients
H-E-B, LP CurrentSince Dec 1, 2020 Accepting new patients
H-E-B, LP Dietitian, Registered CurrentSince Dec 1, 2020 Accepting new patients

Locations

8801 S Congress Ave
Austin, TX 78745
Phone (512) 292-8662

735 SW Military Dr
San Antonio, TX 78221
Phone (210) 927-6875

646 S Flores St
San Antonio, TX 78204
Phone (210) 938-3182

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30127/brand/1/csg/1/fhir/r4

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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1619432432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 S FLORES ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782041219",
            "telephone_number": "855-481-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 S FLORES ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782041219",
            "telephone_number": "855-481-1149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3533 S Alameda St",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784111721",
            "country_code": "US",
            "telephone_number": "361-694-4986 x5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARISSA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86050978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.