EDISON ALEXANDER MARTINEZ (APRN) – Family Nurse Practitioner, NPI 1073219820

EDISON ALEXANDER MARTINEZ (APRN) is a healthcare provider. based in Melbourne, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 11024253 (FL). The NPI Number for EDISON ALEXANDER MARTINEZ (APRN) is 1073219820

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
EDISON ALEXANDER MARTINEZ (APRN)
NPI
1073219820
Phone
(321) 259-9500
Address
6619 N WICKHAM RD
Enumeration Date
3 February 2023
Last Update Date
13 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3212599500
Graduation Year
2022 (4 years ago)
PAC ID
6406221886
Group Practice PAC ID
1951378694
Professional Enrollment ID
I20230418000021
Address ID
FL329402006ME6619XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for EDISON ALEXANDER MARTINEZ (APRN)

  • 6619 N WICKHAM RD

    MELBOURNE, FL 329402006

    Phone: (321) 259-9500

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-04-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230418000021INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32940)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951378694View full group profile
NameSpecialtyState
-FL
Physician AssistantFL
Internal Medicine, Cardiovascular Disease (Cardiology)FL
Family PracticeFL
Nurse PractitionerFL
Family PracticeFL
Internal MedicineFL
Internal MedicineFL
-FL
Family PracticeFL

Reviews

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Frequently asked questions

How do I look up EDISON ALEXANDER MARTINEZ (APRN) by NPI?
Use NPI 1073219820 when you need to reference EDISON ALEXANDER MARTINEZ (APRN) in forms, claims, or directories.
Is EDISON ALEXANDER MARTINEZ (APRN)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does EDISON ALEXANDER MARTINEZ (APRN) work in?
You can think of EDISON ALEXANDER MARTINEZ (APRN) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place EDISON ALEXANDER MARTINEZ (APRN)?
The snapshot lists Melbourne, Florida for EDISON ALEXANDER MARTINEZ (APRN); download NPPES for the complete set.
Is EDISON ALEXANDER MARTINEZ (APRN) a real provider?
This page reflects official NPPES data for NPI 1073219820. Always confirm identity and privileges with the practice and licensing boards.

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