Individual provider Active NPI

Jonathan P Martinez, D.O.

  • General Practice Physician
  • Palmdale, CA
National Provider Identifier
1679764450
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A9822 Issued in CA
Practice address
2270 E Palmdale Blvd
Suite F
Palmdale, CA 93550-4933
Phone
(661) 947-5600
Fax
(661) 947-5900
NPI assigned
Aug 6, 2007
Last updated
Aug 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A9822 CA Primary

Addresses

Primary practice location

2270 E Palmdale Blvd
Suite F
Palmdale, CA 93550-4933

Mailing address

2270 E Palmdale Blvd
Suite F
Palmdale, CA 93550-4933
Phone (661) 947-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071220000230 CA Practitioner - General Practice 2466542915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarzana Treatment Centers IncGroup PAC ID 5991897845, 55 clinicians

Practice addresses (Care Compare)

320 E Palmdale Blvd
Palmdale, CA 93550-4598
Phone (800) 996-1051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9822CAMDGeneral Practice Physician
9822CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Treatment Centers, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Tarzana Treatment Centers, Inc. Current Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Nov 1, 2017 Accepting new patients

Locations

907 W Lancaster Blvd
Lancaster, CA 93534
Phone (661) 723-4829

5190 Atlantic Ave
Long Beach, CA 90805
Phone (562) 428-4111

320 E Palmdale Blvd
Palmdale, CA 93550
Phone (661) 729-9000

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jmartinez347244@direct.ochin.org

Organizations & group practices 4

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1679764450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 E PALMDALE BLVD",
            "address_2": "SUITE F",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504933",
            "telephone_number": "661-947-5600",
            "fax_number": "661-947-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 E PALMDALE BLVD",
            "address_2": "SUITE F",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504933",
            "telephone_number": "661-947-5600",
            "fax_number": "661-947-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A9822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.