MARTHA ASUNCION IBARRA
NPI 1114957289
Nurse Practitioner in San Diego, CA

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
4290 POLK AVE, SAN DIEGO, CA 92105(619) 563-0507(619) 563-0015 Get Directions Write a Review

NPPES record last updated: October 9, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Martha Asuncion Ibarra NPPES

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

MARTHA ASUNCION IBARRA (NPI 1114957289) is an individual nurse practitioner in San Diego, California, licensed in California (NP12112) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1114957289
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMARTHA ASUNCION IBARRA
Location Address4290 POLK AVESan Diego, CA 92105-1524
Mailing Address4290 Polk AveSan Diego, CA 92105-1524 · (619) 563-0507 · Fax (619) 563-0015
Fax(619) 563-0015
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 4, 2006
Last NPPES UpdateOctober 9, 2012
NPI 1114957289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in CA · NP12112
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4290 POLK AVE, San Diego, CA 92105

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

Martha Asuncion Ibarra 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 ID2961395868
PECOS Enrollment IDI20040204000967
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 92105 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

Clinic/Center (Federally Qualified Health Center (FQHC))
4290 POLK AVE
SAN DIEGO, CA 92105
Registered Nurse
4290 POLK AVE
SAN DIEGO, CA 92105
Dietitian, Registered
4290 POLK AVE
SAN DIEGO, CA 92105
Family Medicine
4290 POLK AVE
SAN DIEGO, CA 92105
Internal Medicine
4290 POLK AVE
SAN DIEGO, CA 92105
Psychologist (Clinical)
4290 POLK AVE
SAN DIEGO, CA 92105
Podiatrist
4290 POLK AVE
SAN DIEGO, CA 92105
Physician Assistant
4290 POLK AVE
SAN DIEGO, CA 92105

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114957289, enumerated as an "individual" on July 04, 2006.

The provider is located at 4290 POLK AVE SAN DIEGO, CA 92105 and the phone number is (619) 563-0507.

Nurse Practitioner with taxonomy code 363L00000X.