Active NPI
Moises Manual Martinez, M.D.
- Psychiatry Physician
- Bronx, NY
National Provider Identifier
1669789681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 60 P77237
- Practice address
- 1500 Waters PL
Bronx, NY 10461-2723 - Phone
- (718) 931-0600
- NPI assigned
- Sep 13, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 60 P77237 | NY | Primary |
Addresses
Primary practice location
1500 Waters PL
Bronx, NY 10461-2723
Mailing address
1274 15TH St
Fort Lee, NJ 07024-1939
Phone (201) 224-0473
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60 P77237 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284336000000",
"number": "1669789681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1274 15TH ST",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070241939",
"telephone_number": "201-224-0473",
"fax_number": "201-224-0473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WATERS PL",
"city": "BRONX",
"state": "NY",
"postal_code": "104612723",
"telephone_number": "718-931-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "MOISES",
"middle_name": "MANUAL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-13",
"last_updated": "2010-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "60 P77237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.