Individual provider Active NPI

Rafael Martinez

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1225809460
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3216 Decatur Ave Apt 2B
Bronx, NY 10467-4222
Phone
(646) 730-8483
NPI assigned
Jan 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3216 Decatur Ave Apt 2B
Bronx, NY 10467-4222

Mailing address

3216 Decatur Ave Apt 2B
Bronx, NY 10467-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523000364 NY Practitioner - Physician Assistant 7012359979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 13, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Apr 13, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2025 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: rafmartine@montefioredirect.com

Organizations & group practices 5

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 1

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": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1225809460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 DECATUR AVE APT 2B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104674222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 DECATUR AVE APT 2B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104674222",
            "telephone_number": "646-730-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "RAFAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.