NPIMap

Individual provider Active NPI

Carlos O Martinez, M.D.

  • Nephrology Physician
  • Macon, GA
National Provider Identifier
1841368933
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
031793 Issued in GA
Practice address
165 Emery Hwy
Ste 100
Macon, GA 31217-3666
Phone
(478) 741-2150
Fax
(478) 741-2208
NPI assigned
Nov 30, 2006
Last updated
May 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 031793 GA Primary

Addresses

Primary practice location

165 Emery Hwy
Ste 100
Macon, GA 31217-3666

Mailing address

165 Emery Hwy
Ste 100
Macon, GA 31217-3666
Phone (478) 741-2150

Other identifiers 5

IdentifierTypeStateIssuer
00459841NMedicaidGA
00459841UMedicaidGA
00459841MMedicaidGA
CJ4042OtherGARAILROAD MEDICARE GROUP
390007351OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20041108000802 GA Practitioner - NephrologyPractitioner - Internal Medicine 9133191513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Physicians of Georgia PCGroup PAC ID 7315936341, 4 clinicians

Practice addresses (Care Compare)

165 Emery Hwy
Suite 100
Macon, GA 31217-3613
Phone (478) 741-2150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Warner Robins Dialysis, LLC CurrentSince May 1, 2023 Accepting new patients
Georgia Dialysis Access Center PC Multi-Specialty PastSince Jul 1, 2008 Accepting new patients

Locations

165 Emery Hwy
Ste 100
Macon, GA 31217
Phone (478) 741-2150

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1841368933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 EMERY HWY",
            "address_2": "STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173666",
            "telephone_number": "478-741-2150",
            "fax_number": "478-741-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 EMERY HWY",
            "address_2": "STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173666",
            "telephone_number": "478-741-2150",
            "fax_number": "478-741-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CARLOS",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "031793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459841N",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459841U",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459841M",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CJ4042",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390007351",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.