Individual provider Active NPI

Melissa Diane Martin

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1992161244
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP130804 Issued in TX
Practice address
928 W Commerce St
San Antonio, TX 78207-4444
Phone
(210) 261-1250
NPI assigned
Dec 31, 2015
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TAP8335 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP130804 TX Primary

Addresses

Primary practice location

928 W Commerce St
San Antonio, TX 78207-4444

Mailing address

10050 Great Hills TRL
#1213
Austin, TX 78759-5938

Other practice location 1

10050 Great Hills Trl
#1213
Austin, TX 78759-5938
Phone (512) 487-7198

Other identifiers 1

IdentifierTypeStateIssuer
TAP8335OtherAZAZ STATE BOARD OF NURSING - TYPE: TEMPORARY ADVANCED PRACTITIONER -SPECIALTY:FNP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NV, UT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211005001885 TX Practitioner - Nurse Practitioner 9931507902 Reassigns benefits to 2 organizations
I20251119000598 NV Practitioner - Nurse Practitioner 9931507902 Reassigns benefits to 1 organization
I20251119004993 UT Practitioner - Nurse Practitioner 9931507902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAP8335AZMDFamily Nurse Practitioner
AP130804TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Oct 1, 2021 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Signify Health, LLC CurrentSince Nov 1, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Vpa of Texas PLLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

701 S Carson St
Ste 200
Carson City, NV 89701
Phone (617) 586-0958

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

9980 S 300 W
Ste 200
Sandy, UT 84070
Phone (801) 285-7403

Organizations & group practices 5

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": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1992161244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 GREAT HILLS TRL",
            "address_2": "#1213",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 W COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782074444",
            "telephone_number": "210-261-1250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10050 Great Hills Trl",
            "address_2": "#1213",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787595938",
            "country_code": "US",
            "telephone_number": "512-487-7198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP8335",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP130804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE BOARD OF NURSING - TYPE: TEMPORARY ADVANCED PRACTITIONER -SPECIALTY:FNP",
            "identifier": "TAP8335",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.