Individual provider Active NPI

Eduardo Milton Martinez, M.D.

  • Vascular Surgery Physician
  • Miami, FL
National Provider Identifier
1396845954
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME0068215 Issued in FL
Practice address
3659 S Miami Ave
Suite 4006
Miami, FL 33133-4227
Phone
(786) 483-8438
Fax
(305) 532-7826
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME0068215 FL Primary

Addresses

Primary practice location

3659 S Miami Ave
Suite 4006
Miami, FL 33133-4227

Mailing address

3659 S Miami Ave
Suite 4006
Miami, FL 33133-4227
Phone (786) 483-8438

Other identifiers 1

IdentifierTypeStateIssuer
252061300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180611002028 AL Practitioner - Vascular Surgery 0749220879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Medical College of Wisconsin, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1812 E Main St
Dothan, AL 36301-3000
Phone (334) 794-2825

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0068215FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients
Viera Arango a Partnership of Pas Past Accepting new patients

Locations

102 Doctors Dr
Dothan, AL 36301
Phone (334) 793-8804

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1812 E Main St
Dothan, AL 36301
Phone (334) 793-6573

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.

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1396845954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE",
            "address_2": "SUITE 4006",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334227",
            "telephone_number": "786-483-8438",
            "fax_number": "305-532-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE",
            "address_2": "SUITE 4006",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334227",
            "telephone_number": "786-483-8438",
            "fax_number": "305-532-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EDUARDO",
        "middle_name": "MILTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME0068215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252061300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.