Individual provider Active NPI

Miguel Angel Martinez, MD

  • Family Medicine Physician
  • Fontana, CA
National Provider Identifier
1033472741
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A128522 Issued in CA
Practice address
16854 Ivy Ave Ste a
Fontana, CA 92335-1504
Phone
(909) 791-1000
Fax
(909) 781-6000
NPI assigned
Jun 18, 2012
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A128522 CA Primary

Addresses

Primary practice location

16854 Ivy Ave Ste a
Fontana, CA 92335-1504

Mailing address

4240 Highland Ave
Highland, CA 92346-2764
Phone (909) 674-1900

Other practice location 1

4240 Highland Ave
Highland, CA 92346-2764
Phone (909) 674-1900

Other practice location 2

17051 Sierra Lakes Pkwy Ste 101
Fontana, CA 92336-1274
Phone (909) 864-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150730013866 CA Practitioner - Family Practice 7719291046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Namita Mohideen MD IncGroup PAC ID 1759785934, 9 clinicians

Practice addresses (Care Compare)

15237 Eleventh St
Suite C
Victorville, CA 92395-3736

16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242
Phone (909) 823-8000

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A128522CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Primary Care Inc Family Medicine PastSince May 18, 2025 Accepting new patients
Namita Mohideen MD Inc PastSince May 18, 2025 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1033472741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 HIGHLAND AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462764",
            "telephone_number": "909-674-1900",
            "fax_number": "909-735-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16854 IVY AVE STE A",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351504",
            "telephone_number": "909-791-1000",
            "fax_number": "909-781-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4240 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "CA",
            "postal_code": "923462764",
            "country_code": "US",
            "telephone_number": "909-674-1900",
            "fax_number": "909-735-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17051 Sierra Lakes Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923361274",
            "country_code": "US",
            "telephone_number": "909-864-4700",
            "fax_number": "909-428-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A128522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.