Individual provider Active NPI

Scott Martinez, DC

  • Chiropractor
  • Petaluma, CA
National Provider Identifier
1871370668
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
35162 Issued in CA
Practice address
1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone
(707) 559-7500
NPI assigned
Sep 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 35162 CA Primary

Addresses

Primary practice location

1179 N McDowell Blvd
Petaluma, CA 94954-6559

Mailing address

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

Other practice location 1

5900 State Farm Dr Fl 2
Rohnert Park, CA 94928-2149
Phone (750) 070-7559

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000155 CA Practitioner - Chiropractic 5890143200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35162CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Petaluma Health Center Inc CurrentSince Oct 23, 2023 Accepting new patients
Petaluma Health Center, Inc CurrentSince Oct 23, 2023 Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients

Locations

1179 N McDowell Blvd
Petaluma, CA 94954

5900 State Farm Dr
Fl 2
Rohnert Park, CA 94928
Phone (707) 559-7600

5900 State Farm Dr
Ste 200
Rohnert Park, CA 94928
Phone (707) 559-7600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1871370668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 State Farm Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Rohnert Park",
            "state": "CA",
            "postal_code": "949282149",
            "country_code": "US",
            "telephone_number": "750-070-7559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "35162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.