Individual provider Active NPI

Michael Martinez, M.D.

  • Anesthesiology Physician
  • Racine, WI
National Provider Identifier
1295714707
Registry record updated Dec 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
24574-020 Issued in WI
Practice address
3801 Spring St
Racine, WI 53405-1667
Phone
(262) 687-4011
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 24574-020 WI Primary

Addresses

Primary practice location

3801 Spring St
Racine, WI 53405-1667

Mailing address

PO Box 599
Kenosha, WI 53141-0599
Phone (800) 883-7243

Other identifiers 1

IdentifierTypeStateIssuer
30476900MedicaidWI

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
24574-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Past Accepting new patients
Windy City Anesthesia PC Anesthesiology Past Accepting new patients
Southeast Anesthesiology Anesthesiology Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198368000000",
    "number": "1295714707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 599",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531410599",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SPRING ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2007-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "24574-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30476900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.