Individual provider Active NPI

Amanda Susanne Martinez, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Las Cruces, NM
National Provider Identifier
1760512784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3736 Issued in NM
Practice address
2020 San Patricio Loop
Las Cruces, NM 88011-4203
Phone
(505) 202-2714
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3736 NM Primary

Addresses

Primary practice location

2020 San Patricio Loop
Las Cruces, NM 88011-4203

Mailing address

2020 San Patricio Loop
Las Cruces, NM 88011-4203
Phone (505) 202-2714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221223000353 AZ Practitioner - Qualified Speech Language Pathologist 0648542498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ArizonaGroup PAC ID 8123290392, 10 clinicians

Practice addresses (Care Compare)

1131 E 2ND St
University of Az Speech and Hearing
Tucson, AZ 85721-0071
Phone (520) 626-0620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arizona CurrentSince May 23, 2023 Accepting new patients
The University of Arizona CurrentSince May 23, 2023 Accepting new patients

Locations

1131 E 2nd St
Tucson, AZ 85721
Phone (520) 621-7070

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27327/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760512784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 SAN PATRICIO LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114203",
            "telephone_number": "505-202-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SAN PATRICIO LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114203",
            "telephone_number": "505-202-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AMANDA",
        "middle_name": "SUSANNE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "3736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.