Surelis Yolanda Martinez Cantillo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1009134 Issued in TX

Practice address

155 Elm Forest Loop
Cedar Creek, TX 78612-4021

Phone

(512) 669-2418

NPI assigned

Aug 23, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Lotus Medical Group LLCGroup PAC ID 7113458522, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Blue Lotus Medical Group LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Austin, TX
  • NPI 1578309852
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment NPD
• Trinity Med Care

  • General Practice Physician
  • Aledo, TX
  • NPI 1376485300
  NPD (past)

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1801629837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ELM FOREST LOOP",
            "city": "CEDAR CREEK",
            "state": "TX",
            "postal_code": "786124021",
            "telephone_number": "512-669-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ELM FOREST LOOP",
            "city": "CEDAR CREEK",
            "state": "TX",
            "postal_code": "786124021",
            "telephone_number": "512-669-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ CANTILLO",
        "first_name": "SURELIS",
        "middle_name": "YOLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1009134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hands of Love Occupational Therapy Services
• Roxanne Hazleton, M.ED, LPC
• Sandy M Howard, LMT
• Katrina Alma Kelly, L.M.S.W.
• Genesis Macheck, LMT
• Jameel McAfee, PHLEBOTOMIST
• Sheryl Lynn Michalenko, LMT
• Luis Felipe Ortega
• Hannah Elizabeth Peavy, MAT, LAT, ATC
• Personal Injury Medical Center LLC

• Family Nurse Practitioner in Cedar Creek, TX
• Providers in Cedar Creek, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.