Individual provider Active NPI

Carissa Reanna Martinez, FNP

  • Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1982126595
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0993330-NP Issued in CO
Practice address
4800 Baseline Rd Ste D106
Boulder, CO 80303-2643
Phone
(303) 499-4800
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0200426 CO
Family Nurse Practitioner 363LF0000X APN.0993330-NP CO
Nurse Practitioner 363L00000X 0993330-NP CO Primary

Addresses

Primary practice location

4800 Baseline Rd Ste D106
Boulder, CO 80303-2643

Mailing address

4800 Baseline Rd Ste D106
Boulder, CO 80303-2643
Phone (303) 499-4800

Other practice location 1

14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone (720) 627-3761

Other names 1

  • Carissa Reanna Lopez Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmartinez@rm-uc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20170926001494 CO Practitioner - Nurse Practitioner 4981978277 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone (720) 627-3761

Hospital & facility affiliations

  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0200426COMDRegistered Nurse
0993330-NPCOMDNurse Practitioner
APN.0993330-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2023 Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2023 Accepting new patients
Urgent Care Lakewood Inc CurrentSince Dec 14, 2022 Accepting new patients
True North Health Navigation LLC CurrentSince Sep 1, 2017 Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2023 Accepting new patients
Urgent Care Lakewood Inc CurrentSince Dec 14, 2022 Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

5825 Delmonico Dr
Ste 101
Colorado Springs, CO 80919
Phone (706) 315-2523

12105 W Alameda Pkwy
Ste 100
Lakewood, CO 80228
Phone (303) 988-3600

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

100 Health Park Dr
Louisville, CO 80027
Phone (303) 673-1000

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1982126595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BASELINE RD STE D106",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032643",
            "telephone_number": "303-499-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 BASELINE RD STE D106",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032643",
            "telephone_number": "303-499-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14300 Orchard Pkwy",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "800239206",
            "country_code": "US",
            "telephone_number": "720-627-3761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CARISSA",
        "middle_name": "REANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0200426",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993330-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "0993330-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmartinez@rm-uc.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "4800 Baseline Rd Ste D106",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803032643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "LOPEZ",
            "middle_name": "REANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.