Individual provider Active NPI

Maya Martinez, LAC

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1770975179
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC171237 Issued in OR
Practice address
12732 SE Stark St
Plaza 125 Building G
Portland, OR 97233-1539
Phone
(503) 844-2715
NPI assigned
Feb 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC171237 OR Primary

Addresses

Primary practice location

12732 SE Stark St
Plaza 125 Building G
Portland, OR 97233-1539

Mailing address

6530 SE 63Rd Ave
Portland, OR 97206-7402

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
AC171237ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture by Maya Martinez LLC Acupuncturist CurrentSince May 24, 2020 Accepting new patients

Locations

12732 SE Stark St
Bldg G
Portland, OR 97233
Phone (503) 708-9853

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1770975179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 SE 63RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972067402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12732 SE STARK ST",
            "address_2": "PLAZA 125 BUILDING G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-844-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MAYA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC171237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.