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DR. OFELIA MARTINEZ MD
NPI 1053502567
Pediatrics in New York, NY

Active since August 08, 2007PECOS Enrolled
1879 MADISON AVENUE, NORTH GENERAL HOSPITAL, NEW YORK, NY 10035(212) 423-4500(212) 423-1536 Get Directions Write a Review

NPPES record last updated: August 21, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Ofelia Martinez Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OFELIA MARTINEZ MD (NPI 1053502567) is an individual pediatrics provider in New York, New York, licensed in New York (238864-1) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053502567
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. OFELIA MARTINEZCredential: MD
Location Address1879 MADISON AVENUE, NORTH GENERAL HOSPITALNew York, NY 10035
Mailing Address1879 Madison Avenue, North General HospitalNew York, NY 10035 · (212) 423-4500 · Fax (212) 423-1536
Phone(212) 423-4500
Fax(212) 423-1536
Sole ProprietorNo
Enumeration DateAugust 8, 2007
Last NPPES UpdateAugust 21, 2009
✔ NPI 1053502567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 238864-1
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedInternal MedicineTaxonomy 207R00000X · License 238864-1 (NY)
1879 MADISON AVENUE, New York, NY 10035
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ofelia Martinez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ofelia Martinez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint Peter's University Hospital
34 mi
Clinical
254 EASTON AVE, MANAGED CARE
New Brunswick, NJ 08901
  • Reassigned Medicare billing, New Jersey enrollment
  • Medicare enrollment name: Saint Peters University Hospital
  • 325 clinicians in this Medicare group
NPI 1376079590 (732) 565-5453

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10035 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON AVENUE PHYSICIAN SERVICES PC
Pathology (Anatomic Pathology & Clinical Pathology)
1879 MADISON AVENUE
NEW YORK, NY 10035
New York County (212) 423-4011
DR. ABRAHAM LEE WARSHAW M.D.
Emergency Medicine
1879 MADISON AVENUE, NORTH GENERAL HOSPITAL
NEW YORK, NY 10035
New York County (212) 423-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ofelia Martinez's NPI number?

The NPI number for Ofelia Martinez is 1053502567. It was assigned to this individual provider in the NPPES registry on August 8, 2007.

Where is Ofelia Martinez located?

Ofelia Martinez practices at 1879 Madison Avenue North General Hospital, New York, NY 10035. The listed phone number is (212) 423-4500.

What is Ofelia Martinez's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Ofelia Martinez enrolled in Medicare?

Yes. Ofelia Martinez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ofelia Martinez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ofelia Martinez reassigns Medicare benefits to Saint Peter's University Hospital (New Brunswick, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ofelia Martinez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ofelia Martinez accept?

Health plans from Oscar Health list Ofelia Martinez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ofelia Martinez was last updated on August 21, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.