Individual provider Active NPI

Lourdes Echenique Martin, M.D.

  • Internal Medicine Physician
  • Suffolk, VA
National Provider Identifier
1982724019
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101051494 Issued in VA
Practice address
2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153
Phone
(757) 934-4821
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0101051494 VA
Internal Medicine Physician 207R00000X 0101051494 VA Primary

Addresses

Primary practice location

2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153

Mailing address

2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153
Phone (757) 934-4821

Other identifiers 1

IdentifierTypeStateIssuer
200456OtherVAANTHEM BC BS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105001214 VA Practitioner - Internal MedicinePractitioner - Hospitalist 3870782949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 363-6850

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Feb 17, 2014 Accepting new patients
Internal Medicine Group of Northern Virginia, LTD. Internal Medicine Past Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

2800 Godwin Blvd
#1
Suffolk, VA 23434

2800 Godwin Blvd
Fl 1
Suffolk, VA 23434
Phone (757) 934-4821

2790 Godwin Blvd
Ste 360
Suffolk, VA 23434
Phone (757) 539-3911

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1982724019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 360",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348153",
            "telephone_number": "757-934-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 360",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348153",
            "telephone_number": "757-934-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LOURDES",
        "middle_name": "ECHENIQUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101051494",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101051494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS NUMBER",
            "identifier": "200456",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.