Michael Robert Martinez, O.D.
Individual provider Active NPI Optometrist · Providence, RI
NPI 1770924565 · NPPES record last updated Jul 10, 2013
Key facts
- NPI
- 1770924565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- ODTG00593 (RI)
- Practice address
- 780 N Main St
Providence, RI 02904-5706 - Phone
- (401) 331-2020
- Fax
- (401) 331-1179
- NPI assigned
- Jul 10, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Garden City Eyecare Inc
Practice addresses (Care Compare)
1150 Reservoir Ave
Cranston, RI 02920-6068
Phone (401) 943-8151
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 20 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131121000535 | RI | Practitioner - Optometry | 9032345095 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODTG00593 | RI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aeg Rhode Island Professional, PC | Optometrist | Current |
Accepting new patients |
| Garden City Eyecare, Inc | Optometrist | Current |
Accepting new patients |
Locations
1150 Reservoir Ave
Cranston, RI 02920
Phone (401) 259-0340
1150 Reservoir Ave
Unit LL1
Cranston, RI 02920
Phone (401) 943-8151
780 N Main St
Providence, RI 02904
Phone (401) 331-1108
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODTG00593 | RI | Yes |
Addresses
Primary practice location
780 N Main St
Providence, RI 02904-5706
Mailing address
780 N Main St
Providence, RI 02904-5706
Phone (401) 331-2020
Other providers in Providence, RI
- Candelaria Martinez
- Diosa A Martinez
- Iesha Martinez
- Janely Martinez
- Janisha Martinez
- Rachel Welter Martinez
- Ramonita Rivera Martinez
- Sharlyn Martinez
- Justin Wayne Martino-Harms
- Tara Mitchell Martino
All providers in Providence, RI · Optometrist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.