Organization Active NPI

Agustin Martinez M D P a

  • Primary Care Clinic/Center
  • Hialeah, FL
National Provider Identifier
1992892558
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME82266 Issued in FL
Legal business name
AGUSTIN MARTINEZ M D P A
Practice address
250 E 49TH St
Hialeah, FL 33013-1855
Phone
(305) 822-6885
Fax
(305) 825-9965
NPI assigned
Oct 6, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Authorized official

Name
Agustin Martinez, M.D.NPI 1194762427
Title
Physician
Phone
(305) 822-6885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME82266 FL Primary

Addresses

Primary practice location

250 E 49TH St
Hialeah, FL 33013-1855

Mailing address

1324 SW 143Rd Ave
Miami, FL 33184-3223
Phone (305) 822-6885

Other identifiers 1

IdentifierTypeStateIssuer
261107400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081121000390 FL Part B Supplier - Clinic/Group Practice 0840350716 Receives reassigned benefits from 3 practitioners
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

250 E 49th St
Hialeah, FL 33013
Phone (305) 822-6885

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1992892558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 SW 143RD AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331843223",
            "telephone_number": "305-822-6885",
            "fax_number": "305-825-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330131855",
            "telephone_number": "305-822-6885",
            "fax_number": "305-825-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGUSTIN MARTINEZ M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "AGUSTIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "305-822-6885",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME82266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261107400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.