Active NPI
Jesse Martinez, D.O.
- Internal Medicine Physician
- Plymouth, MI
National Provider Identifier
1699762567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5101012766
- Practice address
- 9377 N Haggerty Rd
Plymouth, MI 48170-4622 - Phone
- (734) 451-0070
- Fax
- (734) 451-1583
- NPI assigned
- Oct 5, 2005
- 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 | 5101012766 | MI | Primary |
Addresses
Primary practice location
9377 N Haggerty Rd
Plymouth, MI 48170-4622
Mailing address
23900 Orchard Lake Rd
Ste 150
Farmington Hills, MI 48336-2500
Phone (248) 234-8690
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4166042-11 | Medicaid | MI | |
| 4387007-11 | Medicaid | MI |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Health Care Associates, PC | Past | Accepting new patients | |
| Park Family Health Care, P.C. | Past | Accepting new patients | |
| Elliott I. Greenspan, D.O., P.C. & Associates | Internal Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1063577641
-
- Family Medicine Physician
- Detroit, MI
- NPI 1437161437
-
- Geriatric Medicine (Internal Medicine) Physician
- Southfield, MI
- NPI 1770694374
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1699762567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23900 ORCHARD LAKE RD",
"address_2": "STE 150",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483362500",
"telephone_number": "248-234-8690",
"fax_number": "248-234-8690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9377 N HAGGERTY RD",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704622",
"telephone_number": "734-451-0070",
"fax_number": "734-451-1583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JESSE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101012766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4166042-11",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4387007-11",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.