NPIMap

Individual provider Active NPI

Marino Antonio Martinez, M.D.

  • Internal Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1750680856
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME110239 Issued in FL
Practice address
4012 Kelcey CT Ste 203
Tallahassee, FL 32308-5968
Phone
(850) 354-8387
Fax
(850) 329-7878
NPI assigned
Mar 15, 2011
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME110239 FL Primary
Hospitalist Physician 208M00000X PENDING FL

Addresses

Primary practice location

4012 Kelcey CT Ste 203
Tallahassee, FL 32308-5968

Mailing address

4012 Kelcey CT Ste 203
Tallahassee, FL 32308-5986
Phone (850) 354-8387

Other practice location 1

69 Gold St
Apartment 11E
New York, NY 10038-1834
Phone (917) 803-0668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110816000357 FL Practitioner - Internal MedicinePractitioner - Emergency Medicine 4183893720 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Enhanced Care PAGroup PAC ID 5092049296, 4 clinicians

Practice addresses (Care Compare)

4012 Kelcey CT
Suite 203
Tallahassee, FL 32308-5986
Phone (850) 354-8387

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
PENDINGFLMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Enhanced Care PA Internal Medicine CurrentSince Jan 16, 2019 Accepting new patients
Deerfield Beach Physician Services, LLC Internal Medicine CurrentSince Jul 23, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Eye Associates of Tallahassee, P.a. Dba Eye Associates of North Florida PastSince Apr 1, 2019 Accepting new patients

Locations

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

4004 Norton Ln
Ste 101
Tallahassee, FL 32308
Phone (850) 518-7626

4012 Kelcey Ct
Ste 203
Tallahassee, FL 32308
Phone (850) 354-8387

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 5

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": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1750680856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 KELCEY CT STE 203",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085986",
            "telephone_number": "850-354-8387",
            "fax_number": "850-329-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 KELCEY CT STE 203",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085968",
            "telephone_number": "850-354-8387",
            "fax_number": "850-329-7878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "69 Gold St",
            "address_2": "Apartment 11E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100381834",
            "country_code": "US",
            "telephone_number": "917-803-0668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARINO",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-15",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME110239",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "PENDING",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.