NPIMap

Individual provider Active NPI

Susan Tracy Martinez, RPA-C

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1730267386
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
006491 Issued in NY
Practice address
210 E 64TH St
4TH Floor- Insall Scott Kelly Institute
New York, NY 10065-7471
Phone
(646) 293-7501
Fax
(646) 293-7502
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 006491 NY Primary

Addresses

Primary practice location

210 E 64TH St
4TH Floor- Insall Scott Kelly Institute
New York, NY 10065-7471

Mailing address

210 E 64TH St FL 4
Insall Scott Kelly Institute for Orthopaedics and Sport
New York, NY 10065-7471
Phone (646) 293-7501

Other identifiers 1

IdentifierTypeStateIssuer
006491OtherNYLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110909002846 NY Practitioner - Physician Assistant 5193995785 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006491NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jul 19, 2021 Accepting new patients
New York University CurrentSince Dec 13, 2016 Accepting new patients
CHS Physician Partners, P.C CurrentSince Mar 1, 2021 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jul 19, 2021 Accepting new patients
New York University CurrentSince Dec 13, 2016 Accepting new patients
CHS Physician Partners, PC CurrentSince Mar 1, 2021 Accepting new patients
City Medical of Upper East Side, PLLC Past Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

210 E 64th St
Fl 4
New York, NY 10065
Phone (212) 434-3365

1865 Broadway
New York, NY 10023
Phone (646) 462-4100

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: susan.martinez.1@2983.direct.athenahealth.com

Organizations & group practices 9

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 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1730267386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 64TH ST FL 4",
            "address_2": "INSALL SCOTT KELLY INSTITUTE FOR ORTHOPAEDICS AND SPORT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657471",
            "telephone_number": "646-293-7501",
            "fax_number": "646-293-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 64TH ST",
            "address_2": "4TH FLOOR- INSALL SCOTT KELLY INSTITUTE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657471",
            "telephone_number": "646-293-7501",
            "fax_number": "646-293-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "SUSAN",
        "middle_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "006491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "006491",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.