Individual provider Active NPI

Mary Martha Ramirez

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1871189464
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1084150 Issued in TX
Practice address
1000 E 5TH St Ste 400
Tyler, TX 75701-3362
Phone
(903) 596-3500
NPI assigned
Dec 17, 2020
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 851442 TX
Family Nurse Practitioner 363LF0000X 1084150 TX Primary

Addresses

Primary practice location

1000 E 5TH St Ste 400
Tyler, TX 75701-3362

Mailing address

1000 E 5TH St Ste 400
Tyler, TX 75701-3362
Phone (903) 596-3500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220901002594 TX Practitioner - Nurse Practitioner 8527442052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians
Ut East Texas Urgent Care Centers, PLLCGroup PAC ID 7517385388, 33 clinicians

Practice addresses (Care Compare)

1000 E 5TH St
Suite 200
Tyler, TX 75701-3313
Phone (903) 594-2666

301 E State Hwy 243
Suite 121
Canton, TX 75103-2418
Phone (903) 567-4692

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
851442TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hope D Short MD PA CurrentSince Aug 1, 2022 Accepting new patients
Etmc Physician Group Inc. CurrentSince May 1, 2024 Accepting new patients
Etmc Physician Group Inc. CurrentSince May 1, 2024 Accepting new patients
Ut East Texas Urgent Care Centers, PLLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

301 E State Highway 243
Ste 121
Canton, TX 75103
Phone (903) 567-4692

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

14069 FM 849
Lindale, TX 75771
Phone (903) 590-5263

6210 S Broadway Ave
Tyler, TX 75703
Phone (903) 579-2700

1000 E 5th St
Ste 200
Tyler, TX 75701
Phone (903) 594-2666

2756 Elkton Trl
Tyler, TX 75703
Phone (903) 534-0911

1000 E 5th St
Ste 400
Tyler, TX 75701
Phone (903) 593-1749

Interoperability endpoints

  • Direct secure messaging: mramirez1004286@ahs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1871189464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST STE 400",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013362",
            "telephone_number": "903-596-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST STE 400",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013362",
            "telephone_number": "903-596-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "MARY",
        "middle_name": "MARTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "851442",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1084150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.