Individual provider Active NPI

Martha Libertad Lara, M.D.

  • Anesthesiology Physician
  • Upland, CA
National Provider Identifier
1811382138
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A146445 Issued in CA
Practice address
999 San Bernardino Rd
Upland, CA 91786-4920
Phone
(949) 920-4851
Fax
(909) 949-3970
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A146445 CA Primary

Addresses

Primary practice location

999 San Bernardino Rd
Upland, CA 91786-4920

Mailing address

PO Box 1628
Orange, CA 92856-0628
Phone (714) 560-1580

Other names 1

  • Martha Libertad Ramirez Muro Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816001096 CA Practitioner - Anesthesiology 7719214576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526

12761 Schabarum Ave
Irwindale, CA 91706-6807
Phone (877) 608-0044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A146445CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 2, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 2, 2020 Accepting new patients
Allied Anesthesia Medical Group Inc Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients

Locations

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1811382138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928560628",
            "telephone_number": "714-560-1580",
            "fax_number": "770-701-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SAN BERNARDINO RD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864920",
            "telephone_number": "949-920-4851",
            "fax_number": "909-949-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "MARTHA",
        "middle_name": "LIBERTAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A146445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "RAMIREZ MURO",
            "middle_name": "LIBERTAD",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.