Individual provider Active NPI

Ryan Michael Martinez, OD

  • Optometrist
  • Reedley, CA
National Provider Identifier
1942723622
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34089TLG Issued in CA
Practice address
1790 E Manning Ave
Reedley, CA 93654-9467
Phone
(559) 643-2790
NPI assigned
Jul 25, 2017
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34089TLG CA Primary

Addresses

Primary practice location

1790 E Manning Ave
Reedley, CA 93654-9467

Mailing address

1790 E Manning Ave
Reedley, CA 93654-9467
Phone (559) 643-2790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181008001469 CA Order and Referring Only - OptometryPractitioner - Optometry 5799037479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34089TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Hospitals Past Accepting new patients
United Health Centers of the San Joaquin Valley Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ryan.martinez.1@17661.direct.athenahealth.com

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1942723622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 E MANNING AVE",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936549467",
            "telephone_number": "559-643-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 E MANNING AVE",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936549467",
            "telephone_number": "559-643-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34089TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedley, CA

Sources for this page

Verify at the official NPI Registry.