| 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 | 11 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 |
| St Luke's Wood River Medical Center | Ketchum, ID | Hospital |
| St Luke's Jerome | Jerome, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic Llc | 1052217478 | 294 |
| 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. Michael Cameron Sweeney, M.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 | |
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: Medicare Enrolled Practice Location: 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301 Phone: 208-814-8700 | |
Andrew Mazzone, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 301, Twin Falls, ID 83301 Phone: 208-814-8700 |