Martin Antonio Carrillo, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G78590 Issued in CA

Practice address

5451 Walnut Ave
Chino, CA 91710-2609

Phone

(909) 464-8666

Fax

(909) 464-8913

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Emergency Medicine

Education

University of California, Davis School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Dimas Emergency Medical Associates Inc.Group PAC ID 0648334235, 10 clinicians

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Dimas Community Hospital Hospital, San Dimas, CA, CCN 050588

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

89.56

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Exer Medical Corporation

  dba Exer Urgent Care

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group NPD
• San Dimas Emergency Medical Associates Inc.

  • Emergency Medicine Physician
  • San Dimas, CA
  • NPI 1720239460
  Medicare reassignment Care Compare group NPD
• Chino Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Chino, CA
  • NPI 1013282029
  Medicare reassignment NPD
• Montclair Emergency Medical Associates

  • Emergency Medicine Physician
  • Montclair, CA
  • NPI 1316044696
  Medicare reassignment NPD
• Telemedicine365 Inc

  • Emergency Medicine Physician
  • El Segundo, CA
  • NPI 1912525817
  NPD
• Chino Emergency Medical Associates

  • Emergency Medicine Physician
  • Chino, CA
  • NPI 1720028525
  NPD (past)
• Glendale Emergency Medical Associates, Inc

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1588606834
  NPD (past)
• Michael S. Agron, M.D., Inc.

  • Emergency Medicine Physician
  • Arcadia, CA
  • NPI 1699716100
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - San Dimas LLC

  dba San Dimas Community Hospital

  • General Acute Care Hospital
  • San Dimas, CA
  • NPI 1740447945
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1861436339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70304",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911177304",
            "telephone_number": "626-792-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-464-8666",
            "fax_number": "909-464-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "MARTIN",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G78590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G785900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl W. Smith, M.D., Inc.
• Taylor Alexis Carpenter, DPT
• Margarita Carpio, PA-C
• Roy Carranza Jr., CCAPP CI28760120
• Peter Paul Carreon, FNP
• Thomas L. Carrillo, PH.D.
• Stephanie A. Carson, LMFT
• Angelique Babette Carter, RN, FNP
• Norman Sheridan Carter, DDS MS
• Gonzalo P Casilang Jr.

• Emergency Medicine Physician in Chino, CA
• Providers in Chino, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.

Verify at the official NPI Registry.