Individual provider Active NPI

Maritza Dotres Martinez, MD

  • Internal Medicine Physician
  • Palm Bay, FL
National Provider Identifier
1447527254
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 48458 Issued in FL
Practice address
6100 Minton Rd NW Ste 102
Palm Bay, FL 32907-1900
Phone
(321) 724-1171
Fax
(321) 724-9024
NPI assigned
Nov 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 48458 FL Primary

Addresses

Primary practice location

6100 Minton Rd NW Ste 102
Palm Bay, FL 32907-1900

Mailing address

95 Bulldog Blvd Ste 202
Melbourne, FL 32901-3188
Phone (321) 727-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120315000684 FL Practitioner - Internal Medicine 3274792940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Healthcare, IncGroup PAC ID 5496652380, 42 clinicians

Practice addresses (Care Compare)

6100 Minton Rd NW
Suite 102
Palm Bay, FL 32907-1900
Phone (321) 724-1171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 48458FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Healthcare, Inc Current Accepting new patients
Omnihealthcare Inc PastSince Feb 1, 2019 Accepting new patients

Locations

95 Bulldog Blvd
Ste 202
Melbourne, FL 32901
Phone (321) 676-1870

1344 S Apollo Blvd
Ste 406
Melbourne, FL 32901
Phone (321) 253-4032

Interoperability endpoints

  • Direct secure messaging: maritzadotresmartinez@ohi.allscriptsdirect.net

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": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1447527254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 BULLDOG BLVD STE 202",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013188",
            "telephone_number": "321-727-2990",
            "fax_number": "321-724-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 MINTON RD NW STE 102",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071900",
            "telephone_number": "321-724-1171",
            "fax_number": "321-724-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTRES MARTINEZ",
        "first_name": "MARITZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 48458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.