Individual provider Active NPI

Deandra Martin, MD

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1730155516
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
J3350 Issued in TX
Practice address
701 S Zarzamora St
San Antonio, TX 78207-5209
Phone
(210) 921-5620
NPI assigned
Feb 23, 2006
Last updated
May 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J3350 TX
Nephrology Physician 207RN0300X J3350 TX Primary

Addresses

Primary practice location

701 S Zarzamora St
San Antonio, TX 78207-5209

Mailing address

7703 Floyd Curl Dr # Mc7977
San Antonio, TX 78229-3901
Phone (210) 921-5620

Other identifiers 2

IdentifierTypeStateIssuer
105844804MedicaidTX
105844802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100111000252 TX Practitioner - NephrologyPractitioner - Internal Medicine 1658442025 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J3350TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Mar 25, 2014 Accepting new patients
University of Texas Health Science Center at San Antonio Internal Medicine Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Mar 25, 2014 Accepting new patients

Locations

701 S Zarzamora St
San Antonio, TX 78207
Phone (210) 358-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 567-6405

7703 Floyd Curl Dr
#7977
San Antonio, TX 78229
Phone (210) 292-0400

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1730155516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR # MC7977",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-921-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S ZARZAMORA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075209",
            "telephone_number": "210-921-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DEANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J3350",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "J3350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105844804",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105844802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.