Individual provider Active NPI

Manuel A. Martinez III, LMSW

  • Social Worker
  • Silver City, NM
National Provider Identifier
1720587058
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M-10105 Issued in NM
Practice address
3082 32ND Street Byp
Silver City, NM 88061
Phone
(575) 538-2061
Fax
(575) 538-5742
NPI assigned
Feb 1, 2018
Last updated
Mar 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-10105 NM Primary

Addresses

Primary practice location

3082 32ND Street Byp
Silver City, NM 88061

Mailing address

700 N Bullard St
Silver City, NM 88061-5413

Other practice location 1

2039 Cottage San Rd
Silver City, NM 88061-8968
Phone (575) 654-2919

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

State licenses

LicenseStateTypeSpecialty
M-10105NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma and Recovery Centers 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, 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": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1720587058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N BULLARD ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3082 32ND STREET BYP",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "88061",
            "telephone_number": "575-538-2061",
            "fax_number": "575-538-5742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2039 Cottage San Rd",
            "address_purpose": "LOCATION",
            "city": "Silver City",
            "state": "NM",
            "postal_code": "880618968",
            "country_code": "US",
            "telephone_number": "575-654-2919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MANUEL",
        "middle_name": "A.",
        "name_suffix": "III",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-01",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-10105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.

Verify at the official NPI Registry.