Active NPI
Kevin Martins
- Student in an Organized Health Care Education/Training Program
- Loma Linda, CA
National Provider Identifier
1912766478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- PTL20547
- Practice address
- 11234 Anderson St
Loma Linda, CA 92350-1716 - Phone
- (909) 558-4000
- NPI assigned
- Mar 18, 2024
- Last updated
- Jul 19, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PTL20547 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92350-1716
Mailing address
11234 Anderson St Ste McB622
Loma Linda, CA 92350-1716
Phone (702) 962-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240517000785 | NV | Order and Referring Only - General Surgery | 8325489693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784419200000",
"number": "1912766478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST STE MCB622",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501716",
"telephone_number": "702-962-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501716",
"telephone_number": "909-558-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINS",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-18",
"last_updated": "2026-07-19",
"certification_date": "2026-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "PTL20547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.