NPIMap

Individual provider Active NPI

James Martin, PA-C

  • Physician Assistant
  • Embudo, NM
National Provider Identifier
1629080643
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2011-0005 Issued in NM
Practice address
Hwy 68 #2243 Rinconada
Embudo, NM 87531
Phone
(505) 579-4255
Fax
(505) 579-4669
NPI assigned
Aug 12, 2006
Last updated
Aug 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2011-0005 NM Primary

Addresses

Primary practice location

Hwy 68 #2243 Rinconada
Embudo, NM 87531

Mailing address

PO Box 158
538 N. Paseo de Onate
Espanola, NM 87532-0158
Phone (505) 753-7218

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Care Network of South Texas PA Past Accepting new patients
The University of Texas Health Science Center at San Antonio Past Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients
University of Texas Health Science Center at San Antonio Past Accepting new patients
El Centro Family Health Past Accepting new patients
Cancer Care Network of South Texas PA Past Accepting new patients

Organizations & group practices 7

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1629080643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "538 N. PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875320158",
            "telephone_number": "505-753-7218",
            "fax_number": "505-753-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 68 #2243 RINCONADA",
            "city": "EMBUDO",
            "state": "NM",
            "postal_code": "87531",
            "telephone_number": "505-579-4255",
            "fax_number": "505-579-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2011-0005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Embudo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.