Individual provider Active NPI

Cristina Del Carmen Martinez, FNP-BC

  • Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1821304569
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00516400 Issued in NJ
Practice address
385 Prospect Ave Ste 204
Hackensack, NJ 07601-2570
Phone
(551) 996-9150
NPI assigned
Aug 18, 2010
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 335859 NY
Family Nurse Practitioner 363LF0000X 5174861 NY
Nurse Practitioner 363L00000X 26NJ00516400 NJ Primary

Addresses

Primary practice location

385 Prospect Ave Ste 204
Hackensack, NJ 07601-2570

Mailing address

385 Prospect Ave Ste 204
Hackensack, NJ 07601-2570

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5174861NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Downstate Medical Center PastSince Apr 1, 2021 Accepting new patients
Premise Health of New York Medical PC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1821304569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 PROSPECT AVE STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 PROSPECT AVE STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012570",
            "telephone_number": "551-996-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CRISTINA",
        "middle_name": "DEL CARMEN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335859",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "5174861",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00516400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.