NPIMap

Individual provider Active NPI

Andres Roberto Chacon Martinez, M.D.

  • Hospitalist Physician
  • Miami, FL
National Provider Identifier
1346775566
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
21514 Issued in NH
Practice address
900 NW 17TH St # 5
Miami, FL 33136-1119
Phone
(305) 243-2742
NPI assigned
Apr 25, 2017
Reactivated
May 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 21514 NH Primary

Addresses

Primary practice location

900 NW 17TH St # 5
Miami, FL 33136-1119

Mailing address

185 SE 14TH Ter Apt 2102
Miami, FL 33131-3420
Phone (561) 766-3472

Other identifiers 1

IdentifierTypeStateIssuer
1346775566MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706001855 NH Practitioner - Hospitalist 1557698495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of NH, LLCGroup PAC ID 8527423706, 88 clinicians
Monadnock Community HospitalGroup PAC ID 7416933031, 67 clinicians

Practice addresses (Care Compare)

1 Parkland Dr
Derry, NH 03038-2746
Phone (603) 432-1500

11 Whitehall Rd
(Frisbie Memorial Hospital)
Rochester, NH 03867-3297
Phone (603) 332-5211

452 Old St Rd
Peterborough, NH 03458-1263
Phone (603) 924-7191

Hospital & facility affiliations

  • Frisbie Memorial Hospital Hospital, Rochester, NH, CCN 300014
  • Monadnock Community Hospital Hospital, Peterborough, NH, CCN 301309
  • Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029
  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • Frisbie Memorial Hospital Inpatient rehabilitation facility, Rochester, NH, CCN 30T014
  • Monadnock Community Hospital Nursing home, CCN 30Z309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21514NHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monadnock Community Hospital CurrentSince Mar 1, 2026 Accepting new patients
Hospital Medicine Services of NH, LLC Hospitalist CurrentSince Apr 1, 2023 Accepting new patients
FMH Health Services, LLC Past Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

452 Old Street Rd
Peterborough, NH 03458
Phone (603) 924-4699

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 3

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 8

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1346775566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SE 14TH TER APT 2102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313420",
            "telephone_number": "561-766-3472",
            "fax_number": "561-766-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NW 17TH ST # 5",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361119",
            "telephone_number": "305-243-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON MARTINEZ",
        "first_name": "ANDRES",
        "middle_name": "ROBERTO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "deactivation_date": "2017-11-27",
        "reactivation_date": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NH",
            "license": "21514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346775566",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.