Individual provider Active NPI

Charles Michael Martinez, MD

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1124190384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
16809 Issued in NY
Practice address
1650 Grand Concourse
Bronx Lebanon Hospital Center Department of Emergency M
Bronx, NY 10457-0000
Phone
(718) 960-1400
Fax
(718) 960-2077
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 16809 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx Lebanon Hospital Center Department of Emergency M
Bronx, NY 10457-0000

Mailing address

48 Decatur Road
New Rochelle, NY 10801-5701
Phone (914) 576-3356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16809NYMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124190384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 DECATUR ROAD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015701",
            "telephone_number": "914-576-3356",
            "fax_number": "718-760-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "BRONX LEBANON HOSPITAL CENTER DEPARTMENT OF EMERGENCY M",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104570000",
            "telephone_number": "718-960-1400",
            "fax_number": "718-960-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "16809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.