Individual provider Active NPI

Christina Ann Martinez, OD

  • Optometrist
  • Lake Havasu City, AZ
National Provider Identifier
1548817786
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002376 Issued in AZ
Practice address
2277 Swanson Ave Ste 100
Lake Havasu City, AZ 86403-5991
Phone
(928) 855-5026
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002376 AZ Primary

Addresses

Primary practice location

2277 Swanson Ave Ste 100
Lake Havasu City, AZ 86403-5991

Mailing address

2277 Swanson Ave Ste 100
Lake Havasu City, AZ 86403-5991
Phone (928) 855-5026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191025002407 AZ Practitioner - Optometry 8123350048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Havasu Family Eyecare LLCGroup PAC ID 0749220051, 10 clinicians

Practice addresses (Care Compare)

2277 Swanson Ave
Suite 100
Lake Havasu City, AZ 86403-6141
Phone (928) 855-5026

Merit-based Incentive Payment System (MIPS)

Final score
82.83 of 100Reported as group
Quality
65.65
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002376AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Havasu Family Eyecare, LLC Optometrist CurrentSince Aug 22, 2019 Accepting new patients

Locations

2277 Swanson Ave
Ste 100
Lk Havasu Cty, AZ 86403
Phone (928) 706-9991

Organizations & group practices 1

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1548817786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 SWANSON AVE STE 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035991",
            "telephone_number": "928-855-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 SWANSON AVE STE 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035991",
            "telephone_number": "928-855-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT002376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.