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MARTINDALE FAMILY MEDICINE CLINIC PA
NPI 1265917959
Family Medicine in Waco, TX

Active since September 27, 2018CLIA 45D0928918 · Microscopy
7104 NEW SANGER AVE, WACO, TX 76712(254) 262-3188(254) 224-8984 Get Directions Write a Review

NPPES record last updated: September 27, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Martindale Family Medicine Clinic Pa NPPES

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

MARTINDALE FAMILY MEDICINE CLINIC PA (NPI 1265917959) is a healthcare organization registered as a family medicine in Waco, Texas and active in the NPI registry since September 2018. The organization holds a CLIA Microscopy certificate valid through April 6, 2028 and lists Timothy Martindale, Physician, as its authorized official.

NPPES Registry Identity

NPI1265917959
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMARTINDALE FAMILY MEDICINE CLINIC PA
Location Address7104 NEW SANGER AVEWaco, TX 76712-3928
Mailing Address7104 New Sanger AveWaco, TX 76712-3928 · (254) 262-3188 · Fax (254) 224-8984
Phone(254) 262-3188
Fax(254) 224-8984
Organization SubpartNo
Authorized OfficialTimothy MartindalePhysician · (254) 262-3188
Enumeration DateSeptember 27, 2018
✔ NPI 1265917959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
7104 NEW SANGER AVE, Waco, TX 76712
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Martindale Family Medicine Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Martindale Family Medicine Clinic PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jessica Dine, APRN, FNP-BC
Nurse Practitioner
NPI 1073155719
7104 NEW SANGER AVE
Waco, TX 76712
(254) 262-3188
✔ PECOS✔ Accepts MedicareSame address
Timothy Martindale, MD
Family Practice
NPI 1003824632
7104 NEW SANGER RD
Waco, TX 76712
(254) 741-1113
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0928918

Martindale Family Medicine Clinic · Waco, TX
Active · expires Apr 6, 2028
CLIA Number45D0928918
Laboratory TypeCommunity Clinic
Certificate Effective DateApril 7, 2026
Certificate Expiration DateApril 6, 2028
Laboratory DirectorTimothy Martindale
Laboratory Phone(254) 644-5950
Laboratory LocationMartindale Family Medicine Clinic7104 New Sanger, Waco, TX 76712
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Martindale Family Medicine Clinic PA's NPI number?

The NPI number for Martindale Family Medicine Clinic PA is 1265917959. It was assigned to this organization in the NPPES registry on September 27, 2018.

Where is Martindale Family Medicine Clinic PA located?

Martindale Family Medicine Clinic PA is located at 7104 New Sanger Ave, Waco, TX 76712. The listed phone number is (254) 262-3188.

What is Martindale Family Medicine Clinic PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Martindale Family Medicine Clinic PA enrolled in Medicare?

Yes. Martindale Family Medicine Clinic PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Martindale Family Medicine Clinic PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Martindale Family Medicine Clinic PA, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Martindale Family Medicine Clinic PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0928918) is associated with this NPI, valid through April 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Martindale Family Medicine Clinic PA was last updated on September 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.