Edward Justin Martinez, | |
775 Pole Line Rd W Ste 301, Twin Falls, ID 83301-5823 | |
(208) 814-8700 | |
Not Available |
Full Name | Edward Justin Martinez |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 10 Years |
Location | 775 Pole Line Rd W Ste 301, Twin Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578983524 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 279546 (Massachusetts) | Secondary |
208800000X | Urology | M-16287 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
Stamford Hospital | Stamford, CT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Lukes Clinic Llc | 1052217478 | 274 |
Stamford Health Medical Group Inc | 6901099746 | 356 |
Entity Name | St Lukes Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
Mailing Address | Practice Location Address |
---|---|
Edward Justin Martinez, 190 E Bannock St, Boise, ID 83712-6241 Ph: (120) 838-1877 | Edward Justin Martinez, 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301-5823 Ph: (208) 814-8700 |
Dr. Nikolai Sopko, M.D., PH.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301 Phone: 208-814-8700 Fax: 208-933-4914 | |
Joel Hancock, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2114 Village Park Ave, Twin Falls, ID 83301 Phone: 208-733-3404 Fax: 866-939-1381 | |
Dr. Jeremy L Weiss, DO Urology Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301 Phone: 208-814-8700 Fax: 208-933-4914 | |
Steven B. Kurtz, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301 Phone: 208-814-8700 | |
Andrew Mazzone, M.D. Urology Medicare: Medicare Enrolled Practice Location: 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301 Phone: 208-814-8700 | |
Dr. Cory Scott Bates, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W, Suite 301, Twin Falls, ID 83301 Phone: 208-814-8700 Fax: 208-933-4914 |