Individual provider Active NPI

Carlos Jose Martin II

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1699378562
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
215667 Issued in LA
Practice address
5800 One Perkins Place Dr Ste a
Baton Rouge, LA 70808-9113
Phone
(225) 831-1241
NPI assigned
Nov 20, 2020
Last updated
Nov 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 215667 LA Primary
Emergency Registered Nurse 163WE0003X RN150143 LA

Addresses

Primary practice location

5800 One Perkins Place Dr Ste a
Baton Rouge, LA 70808-9113

Mailing address

5800 One Perkins Place Dr Ste a
Baton Rouge, LA 70808-9113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210115000828 LA Practitioner - Nurse Practitioner 2769895507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCP Urgent Care Holdings LLCGroup PAC ID 5092016816, 47 clinicians

Practice addresses (Care Compare)

2840 Florida St
Baton Rouge, LA 70802-2721
Phone (225) 224-2402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN150143LAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
PCP Urgent Care Holdings LLC CurrentSince Jan 1, 2021 Accepting new patients
PCP Urgent Care Holdings LLC CurrentSince Jan 1, 2021 Accepting new patients
R.T. Royal Group LLC PastSince Jul 28, 2019 Accepting new patients

Locations

14879 Tiger Bend Rd
Baton Rouge, LA 70817
Phone (225) 257-7782

2840 Florida St
Baton Rouge, LA 70802
Phone (225) 224-2402

5420 Plank Rd
Baton Rouge, LA 70805
Phone (225) 228-2452

8540 Siegen Ln
Ste A
Baton Rouge, LA 70810

8540 Siegen Ln
Ste B
Baton Rouge, LA 70810
Phone (225) 224-8690

9688 Florida Blvd
Baton Rouge, LA 70815
Phone (225) 408-7587

409 Oak Plaza Blvd
Brusly, LA 70719
Phone (225) 877-3700

1706 SW Railroad Ave
Ste A
Hammond, LA 70403
Phone (985) 826-7782

17513 Old Jefferson Hwy
Prairieville, LA 70769
Phone (225) 673-7587

Organizations & group practices 3

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": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1699378562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 ONE PERKINS PLACE DR STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 ONE PERKINS PLACE DR STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089113",
            "telephone_number": "225-831-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CARLOS",
        "middle_name": "JOSE",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "215667",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "LA",
            "license": "RN150143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.