Martina O Ezigbo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61594748 Issued in WA

Practice address

101 Elliott Ave W Ste 500
Seattle, WA 98119-4292

Phone

(425) 640-7009

NPI assigned

Dec 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CO, PA, NY, WA, CA6 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 6

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Supportive Care of Texas PCGroup PAC ID 1658744503, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Supportive Care of Texas PC

  • Nurse Practitioner
  • Garland, TX
  • NPI 1174247126
  Medicare reassignment Care Compare group NPD
• Grassroot Psychiatry and Mental Health Clinic PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1801625926

  CO, PA

  Medicare reassignment Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY, PA, Psychiatric/Mental Health, TX

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Kinghaven Counseling Group Inc

  • Case Management Agency
  • Houston, TX
  • NPI 1396807350
  NPD (past)
• Zhe Song, MD PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sugar Land, TX
  • NPI 1548034721
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1679285472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ELLIOTT AVE W STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981194292",
            "telephone_number": "425-640-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 N Hwy 360 Ste 405B",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750501025",
            "country_code": "US",
            "telephone_number": "682-453-6176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZIGBO",
        "first_name": "MARTINA",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61594748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Marie Eykamp
• Lauren Eykholt, OT
• Christine Eyler, DNP
• Ted A Eytan, M.D.
• Tracy D Ezell
• Thomas Faanoma
• Alene Isabelle Faber, MSW, LICSW
• Garret Michael Fabian, EAMP, L.AC.
• Polly T Fabian, M.D.
• Ivan Fabic, RRT-ACCS

• Psychiatric/Mental Health Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.