CMS-1500 Box 24J / 33a • NPI
1417560665
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
164X00000X
Licensed & Credentialed Licensed Vocational Nurse
Box 32 Service Location & ZIP+4
104 N NOLAN AVE, CAMERON, TX, 76520-3255
✓ 9-Digit EDI 837 ZIP+4 (76520-3255)
⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT:
NPI
1417560665 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(2) — Conviction Relating to Patient Abuse or Neglect — Effective 2026-03-19). Verify before submitting Medicare/Medicaid claims.
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1417560665 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JOSE ALEJANDRO MARTINEZ, LVN |
| Plain-English Specialty | Licensed & Credentialed Licensed Vocational Nurse NUCC Code: 164X00000X (Licensed Vocational Nurse) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 104 N NOLAN AVE, CAMERON, TX, 76520-3255 |
| Practice Telephone / Fax | Tel: (254) 421-3979 |
| Administrative Mailing Address | 104 N NOLAN AVE, CAMERON, TX, 76520-3255 |
| Enumeration & Last Sync | Enumerated: 2020-08-27 | CMS Record Updated: 2020-08-27 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (164X00000X)
What Does Taxonomy Code 164X00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 164X00000X translates to:
"Licensed & Credentialed Licensed Vocational Nurse"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JOSE ALEJANDRO MARTINEZ, LVN)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
164X00000X — Licensed Vocational NursePlain English: Licensed & Credentialed Licensed Vocational Nurse | State: TX | License: 350461 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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