James Martin, PA-C

Individual provider Active NPI Physician Assistant · Embudo, NM

NPI 1629080643 · NPPES record last updated Aug 2, 2013

Key facts

NPI
1629080643
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA2011-0005 (NM)
Practice address
Hwy 68 #2243 Rinconada
Embudo, NM 87531
Phone
(505) 579-4255
Fax
(505) 579-4669
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2011-0005NMMDPhysician 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
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
El Centro Family Health Past Accepting new patients

Specialties & licenses

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

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

Other providers in Embudo, NM

All providers in Embudo, NM · Physician Assistant in New Mexico

Sources for this page

Verify at the official NPI Registry.