Active NPI
Deogracias Rufino Martinez Jr., MD
- Internal Medicine Physician
- Las Vegas, NV
National Provider Identifier
1679652796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 8869
- Practice address
- 2704 N Tenaya Way
Las Vegas, NV 89128-0424 - Phone
- (702) 243-8500
- Fax
- (702) 560-2928
- NPI assigned
- Nov 2, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 8869 | NV | Primary |
Addresses
Primary practice location
2704 N Tenaya Way
Las Vegas, NV 89128-0424
Mailing address
PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 243-8500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0021600 | Medicaid | CA | |
| 1679652796 | Other | NV | SMA MEDICAID |
| V108086 | Other | NV | SMA MEDICARE |
Other names 1
- Deo Martinez
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32000 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deo Martinez MD PC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Moreno Valley, CA
- NPI 1962560235
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1679652796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15645",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891145645",
"telephone_number": "702-243-8500",
"fax_number": "702-560-2928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2704 N TENAYA WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280424",
"telephone_number": "702-243-8500",
"fax_number": "702-560-2928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "DEOGRACIAS",
"middle_name": "RUFINO",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "8869",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0021600",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SMA MEDICAID",
"identifier": "1679652796",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SMA MEDICARE",
"identifier": "V108086",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEO",
"last_name": "MARTINEZ",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.