Individual provider Active NPI

Dora Alicia Martinez, M.D

  • Family Medicine Physician
  • Santa Rosa, TX
National Provider Identifier
1811217003
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TEMPORARY LICENSE Issued in TX
Practice address
122 FM 506
Santa Rosa, TX 78593-0226
Phone
(956) 365-6071
Fax
(956) 365-6072
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEMPORARY LICENSE TX Primary

Addresses

Primary practice location

122 FM 506
Santa Rosa, TX 78593-0226

Mailing address

1706 Treasure Hills Blvd
Harlingen, TX 78550-8911
Phone (956) 365-6750

Other identifiers 1

IdentifierTypeStateIssuer
TEMPORARY LICENSEOtherTXTMB

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
I20100907000033 TX Practitioner - Family Practice 1557485018 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley AIDS Council CurrentSince Sep 1, 2014 Accepting new patients

Locations

857 E Washington St
Ste G
Brownsville, TX 78520
Phone (956) 541-2600

2306 Camelot Plaza Cir
Harlingen, TX 78550
Phone (956) 428-2653

Interoperability endpoints

  • Direct secure messaging: dora.martinez@wc10.eclinicaldirectplus.com

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1811217003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 TREASURE HILLS BLVD",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508911",
            "telephone_number": "956-365-6750",
            "fax_number": "956-365-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 FM 506",
            "city": "SANTA ROSA",
            "state": "TX",
            "postal_code": "785930226",
            "telephone_number": "956-365-6071",
            "fax_number": "956-365-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "DORA",
        "middle_name": "ALICIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "TEMPORARY LICENSE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMB",
            "identifier": "TEMPORARY LICENSE",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, TX

Sources for this page

Verify at the official NPI Registry.