Individual provider Active NPI

Bernardo D Martinez, MD

  • Vascular Surgery Physician
  • Overland Park, KS
National Provider Identifier
1538159983
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0447181 Issued in KS
Practice address
11025 Metcalf Avenue
Overland Park, KS 66210
Phone
(913) 912-3624
Fax
(913) 717-6362
NPI assigned
Oct 26, 2005
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0447181 KS Primary
Vascular Surgery Physician 2086S0129X 35039917 OH

Addresses

Primary practice location

11025 Metcalf Avenue
Overland Park, KS 66210

Mailing address

11025 Metcalf Avenue
Overland Park, KS 66210
Phone (913) 912-3624

Other identifiers 1

IdentifierTypeStateIssuer
0372430MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230512000746 KS Practitioner - Vascular Surgery 3870644958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11025 Metcalf Ave
Overland Park, KS 66210-1815
Phone (913) 912-3624

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0447181KSMDVascular Surgery Physician
35039917OHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martinez Vascular Institute and Wellness LLC Vascular Surgery CurrentSince Mar 15, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Bernardo D. Martinez,M.D.,F,a,C,S, Inc. Past Accepting new patients

Locations

11025 Metcalf Ave
Overland Park, KS 66210
Phone (913) 912-3624

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIGBDD/Endpoint/HIGBDD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1538159983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11025 METCALF AVENUE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-912-3624",
            "fax_number": "913-717-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11025 METCALF AVENUE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-912-3624",
            "fax_number": "913-717-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "BERNARDO",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KS",
            "license": "0447181",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35039917",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0372430",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.