Individual provider Active NPI

Martin R Chavez, MD

  • Maternal & Fetal Medicine Physician
  • Mineola, NY
National Provider Identifier
1356411375
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
25MA06683400 Issued in NJ
Practice address
120 Mineola Blvd
Suite 100
Mineola, NY 11501-4064
Phone
(516) 663-3010
Fax
(516) 663-3026
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 25MA06683400 NJ Primary

Addresses

Primary practice location

120 Mineola Blvd
Suite 100
Mineola, NY 11501-4064

Mailing address

700 Hicksville Rd
Suite 204
Bethpage, NY 11714-3471
Phone (516) 576-6106

Other identifiers 1

IdentifierTypeStateIssuer
02961195MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mchavez208572@nyumc.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080911000525 NY Practitioner - Obstetrics/Gynecology 9739175803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06683400NJMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 1, 2017 Accepting new patients
New York University CurrentSince Dec 1, 2017 Accepting new patients
Ilene Gewirtz GYN, P.C. Past Accepting new patients

Locations

369 E Main St
Ste 11
East Islip, NY 11730
Phone (631) 859-9793

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

7801 Myrtle Ave
Glendale, NY 11385
Phone (718) 326-4332

600 Northern Blvd
Ste 106
Great Neck, NY 11021
Phone (516) 466-4128

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 100
Mineola, NY 11501
Phone (516) 663-2010

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

70 E Sunrise Hwy
Ste 515
Valley Stream, NY 11581
Phone (516) 536-5656

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1356411375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HICKSVILLE RD",
            "address_2": "SUITE 204",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143471",
            "telephone_number": "516-576-6106",
            "fax_number": "516-576-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 100",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014064",
            "telephone_number": "516-663-3010",
            "fax_number": "516-663-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "MARTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "25MA06683400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02961195",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchavez208572@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "120 Mineola Blvd",
            "address_2": "Suite 100",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.