Individual provider Active NPI

Kathleen Marie Martinez, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1790934008
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5508 Issued in AZ
Practice address
2411 W Northern Ave Ste 201
Phoenix, AZ 85021-4874
Phone
(480) 712-4600
Fax
(602) 428-7045
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5508 AZ Primary

Addresses

Primary practice location

2411 W Northern Ave Ste 201
Phoenix, AZ 85021-4874

Mailing address

PO Box 20216
Phoenix, AZ 85036-0216
Phone (480) 712-4600

Other practice location 1

27 W Ridgecrest Rd
Phoenix, AZ 85086-6520
Phone (602) 363-2285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230518002788 AZ Practitioner - Physical Therapist in Private Practice 3678939568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Recovia Physical Therapy LLCGroup PAC ID 4880949148, 20 clinicians

Practice addresses (Care Compare)

2411 W Northern Ave
Suite 201
Phoenix, AZ 85021-4874
Phone (480) 712-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Recovia Physical Therapy, LLC Physical Therapist CurrentSince Feb 27, 2023 Accepting new patients

Locations

19636 N 27th Ave
Ste 106
Phoenix, AZ 85027
Phone (480) 416-7200

337 E Coronado Rd
Ste 201
Phoenix, AZ 85004
Phone (602) 252-8081

2411 W Northern Ave
Ste 201
Phoenix, AZ 85021
Phone (602) 441-1750

1910 E Southern Ave
Tempe, AZ 85282
Phone (480) 219-7178

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1790934008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20216",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850360216",
            "telephone_number": "480-712-4600",
            "fax_number": "602-428-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 W NORTHERN AVE STE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214874",
            "telephone_number": "480-712-4600",
            "fax_number": "602-428-7045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 W Ridgecrest Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850866520",
            "country_code": "US",
            "telephone_number": "602-363-2285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.