MARTINA SARA CORDOVA FNP
NPI 1114793643
Nurse Practitioner - Family in Clearlake, CA

Q: What is Martina Cordova's NPI number?

The NPI number for Martina Cordova is 1114793643. It was assigned to this individual provider in the NPPES registry on November 27, 2023.

Q: What is Martina Cordova's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Martina Cordova was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 27, 2023PECOS EnrolledAccepts Medicare Assignment

15630 18TH AVE, CLEARLAKE, CA 95422(707) 994-6486 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Martina Sara Cordova Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARTINA SARA CORDOVA FNP (NPI 1114793643) is an individual family provider in Clearlake, California, licensed in California (95026363) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1114793643

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARTINA SARA CORDOVACredential: FNP

Location Address15630 18TH AVEClearlake, CA 95422-9336

Mailing Address1583 Gladstone WayRohnert Park, CA 94928-1592 · (650) 455-1109

Phone(707) 994-6486

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateNovember 27, 2023

NPPES CertifiedNovember 27, 2023

✔ NPI 1114793643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95026363

15630 18TH AVE, Clearlake, CA 95422

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Martina Sara Cordova Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951746130

PECOS Enrollment IDI20240227003597

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95422 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KONOCTI EMERGENCY PHYSICIANS

Emergency Medicine