Healthcare Provider Details

I. General information

NPI: 1659046241
Provider Name (Legal Business Name): ONERGIS EMMANUEL MARTINEZ PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S 1ST ST
MOUNT HOREB WI
53572-1906
US

IV. Provider business mailing address

538 W WASHINGTON AVE APT 501
MADISON WI
53703-4777
US

V. Phone/Fax

Practice location:
  • Phone: 608-924-6018
  • Fax:
Mailing address:
  • Phone: 262-729-7149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: