LA TISHA MARTINEZ NP
NPI 1174367312
Nurse Practitioner in Albuquerque, NM

Q: What is La Tisha Martinez's NPI number?

The NPI number for La Tisha Martinez is 1174367312. It was assigned to this individual provider in the NPPES registry on June 22, 2024.

Q: What is La Tisha Martinez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for La Tisha Martinez was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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 June 22, 2024PECOS EnrolledAccepts Medicare Assignment

3825 EUBANK BLVD NE STE A, ALBUQUERQUE, NM 87111(052) 928-5755(505) 292-8409 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 10, 2025, Feb 4, 2025, Jun 22, 2024 (3 updates tracked since 2024).

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About La Tisha Martinez Np NPPES

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

LA TISHA MARTINEZ NP (NPI 1174367312) is an individual nurse practitioner in Albuquerque, New Mexico, licensed in New Mexico (79563) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1174367312

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameLA TISHA MARTINEZCredential: NP

Location Address3825 EUBANK BLVD NE STE AAlbuquerque, NM 87111-3590

Mailing Address5900 Canyon Vista Dr NeAlbuquerque, NM 87111-6621 · (505) 400-0693

Phone(052) 928-5755

Fax(505) 292-8409

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJune 22, 2024

Last NPPES UpdateMarch 10, 20253 updates tracked since enumeration

NPPES CertifiedMarch 10, 2025

✔ NPI 1174367312 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 NM · 79563

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.

3825 EUBANK BLVD NE STE A, Albuquerque, NM 87111

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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

La Tisha Martinez Np 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 ID9032645940

PECOS Enrollment IDI20241216000044

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 87111 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

$84.79 typical visit price

range $54.26 – $166.80

Typical copayment $21.19 (range $13.56 – $41.70)

Most-billed visit code 99203

Established Patient

$96.38 typical visit price

range $17.00 – $135.35

Typical copayment $24.09 (range $4.25 – $33.83)

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 13

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

MRS. JESSIKA JUNICK NP-C

Nurse Practitioner (Family)