NPIMap

Individual provider Active NPI

Marco A Martinez, M.D.

  • Nephrology Physician
  • Cudahy, CA
National Provider Identifier
1700924909
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A54076 Issued in CA
Practice address
4566 Florence Ave
Suite # 5
Cudahy, CA 90201-4345
Phone
(323) 771-7466
Fax
(323) 771-4920
NPI assigned
Feb 1, 2007
Last updated
Jun 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A54076 CA Primary

Addresses

Primary practice location

4566 Florence Ave
Suite # 5
Cudahy, CA 90201-4345

Mailing address

4566 Florence Ave
Suite # 5
Cudahy, CA 90201-4345
Phone (323) 771-7466

Other identifiers 1

IdentifierTypeStateIssuer
00A540761MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910000102 CA Practitioner - Internal MedicinePractitioner - NeurologyPractitioner - Nephrology 9739179078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4566 E Florence Ave
Suite 5
Cudahy, CA 90201-4346
Phone (323) 771-7466

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54076CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marco a. Martinez, M.D. Inc Internal Medicine CurrentSince Nov 6, 2000 Accepting new patients
Cudahy Peritoneal Dialysis Center CurrentSince Jul 19, 2020 Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
East la Dialysis Center PastSince Feb 13, 2004 Accepting new patients

Locations

4566 Florence Ave
Ste 5
Bell, CA 90201
Phone (323) 771-7466

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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

Hospital & facility affiliations 8

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1700924909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 FLORENCE AVE",
            "address_2": "SUITE # 5",
            "city": "CUDAHY",
            "state": "CA",
            "postal_code": "902014345",
            "telephone_number": "323-771-7466",
            "fax_number": "323-771-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 FLORENCE AVE",
            "address_2": "SUITE # 5",
            "city": "CUDAHY",
            "state": "CA",
            "postal_code": "902014345",
            "telephone_number": "323-771-7466",
            "fax_number": "323-771-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARCO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A54076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A540761",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cudahy, CA

Sources for this page

Verify at the official NPI Registry.