Active NPI
Ricardo R Martinez, MD
- Interventional Cardiology Physician
- Port Charlotte, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- ME67623
- Practice address
- 3340 Tamiami TRL
Port Charlotte, FL 33952-8088 - Phone
- (941) 764-5858
- Fax
- (941) 764-1657
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME0067623 | FL | |
| Interventional Cardiology Physician | 207RI0011X | ME67623 | FL | Primary |
Addresses
Primary practice location
3340 Tamiami TRL
Port Charlotte, FL 33952-8088
Mailing address
2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260918500 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Howard University College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3340 Tamiami TRL
Port Charlotte, FL 33952-8088
Phone (941) 237-7100
Hospital & facility affiliations
- Adventhealth Port Charlotte
- HCA Florida Fawcett Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0067623 | FL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Physician Group LLC | Current | Accepting new patients | |
| Millennium Physician Group LLC | Current | Accepting new patients | |
| Advanced Imaging of Port Charlotte | Past | Accepting new patients |
Locations
2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700
3340 Tamiami Trl
Pt Charlotte, FL 33952
Phone (941) 764-5858
2525 Harbor Blvd
Ste 104
Pt Charlotte, FL 33952
Phone (941) 629-5757
19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535
25097 Olympia Ave
Ste 102
Punta Gorda, FL 33950
Phone (941) 237-7100
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- ricardo.martinez.1@4290.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Fort Myers, FL
- NPI 1811122880
-
- Family Medicine Physician
- Brooksville, FL
- NPI 1073131702
-
- Diagnostic Radiology Physician
- Port Charlotte, FL
- NPI 1225361850
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1760299093
-
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1417901406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1780697706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2675 WINKLER AVE FL 2",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339019342",
"telephone_number": "877-856-3774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 TAMIAMI TRL",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339528088",
"telephone_number": "941-764-5858",
"fax_number": "941-764-1657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "RICARDO",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME0067623",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "FL",
"license": "ME67623",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260918500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.