Individual provider Active NPI

Lara Martinez

  • Emergency Medicine Physician
  • Dayton, OH
National Provider Identifier
1003303751
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A19542 Issued in CA
Practice address
405 W Grand Ave
Dayton, OH 45405-7538
Phone
(937) 723-3245
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.014062 OH
Emergency Medicine Physician 207P00000X 20A19542 CA Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-7538

Mailing address

405 W Grand Ave
Dayton, OH 45405-7538

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Other practice location 2

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 3

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200928000605 OH Practitioner - Emergency Medicine 3678821949 Reassigns benefits to 1 organization
I20220811001622 CA Practitioner - Emergency Medicine 3678821949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

2550 Sister Mary Columba Dr
Red Bluff, CA 96080-4327
Phone 53052980000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
19542CAMDChiropractor
20A19542CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Emergency Medicine Physicians of Champaign County LTD Emergency Medicine CurrentSince Aug 8, 2021 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

27300 Iris Ave
Moreno Valley, CA 92555
Phone (909) 243-0811

2550 Sister Mary Columba Dr
Red Bluff, CA 96080
Phone (530) 529-8000

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1003303751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454057538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454057538",
            "telephone_number": "937-723-3245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.014062",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A19542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.