Enrique Jose Moreno Martinez, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

28693 Issued in NE

Practice address

1111 Broadway Suite 305
Chuia Vista, CA 91911

Phone

(619) 567-7007

Fax

(619) 567-7775

NPI assigned

Jun 27, 2010

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Specialty

Vascular Surgery

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

San Diego Cardiovascular and Thoracic Surgeons IncGroup PAC ID 2264335702, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
• Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

78.64

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment Care Compare group NPD
• San Diego Cardiovascular and Thoracic Surgeons, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • San Diego, CA
  • NPI 1790766038
  Medicare reassignment Care Compare group NPD
• Sasha Salloum MD Inc a Professional Medical Corporation

  dba SS Vascular

  • Vascular Surgery Physician
  • Chula Vista, CA
  • NPI 1578949889
  Medicare reassignment
• Vascular Associates of San Diego

  • Vascular Surgery Physician
  • La Mesa, CA
  • NPI 1104975713
  NPD (past)

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

• Sharp Coronado Hospital and Healthcare Center

  dba Sharp Coronado Hospital

  • General Acute Care Hospital
  • Coronado, CA
  • NPI 1154304475
  Care Compare affiliation
• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1225349079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BROADWAY SUITE 305",
            "city": "CHUIA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-567-7007",
            "fax_number": "619-567-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BROADWAY SUITE 305",
            "city": "CHUIA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-567-7007",
            "fax_number": "619-567-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO MARTINEZ",
        "first_name": "ENRIQUE",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-27",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "28693",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME121618",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME121618",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NE",
            "license": "28693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.