1. Home
  2. Directory
  3. New Jersey
  4. Sparta
  5. Optometrist
  6. NPI Profile

ELENA MARTINEZ O.D
NPI 1093166290
Optometrist in Sparta, NJ

Active since June 29, 2016PECOS EnrolledAccepts Medicare Assignment
117 SPARTA AVE, SPARTA, NJ 07871(973) 726-0669 Get Directions Write a Review

NPPES record last updated: June 29, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Elena Martinez O.d NPPES

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

ELENA MARTINEZ O.D (NPI 1093166290) is an individual optometrist in Sparta, New Jersey, licensed in New Jersey (27OA00666600) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1093166290
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameELENA MARTINEZCredential: O.D
Location Address117 SPARTA AVESparta, NJ 07871-1773
Mailing Address117 Sparta AveSparta, NJ 07871-1773 · (973) 726-0669
Phone(973) 726-0669
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 29, 2016
✔ NPI 1093166290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in NJ · 27OA00666600✔ Licensed in NJ · 27OM00134600
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
117 SPARTA AVE, Sparta, NJ 07871
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Elena Martinez O.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810280294
PECOS Enrollment IDI20160722000081
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 Elena Martinez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northwest Optometry Group, P.A.
Same address
Optometrist
117 SPARTA AVE
Sparta, NJ 07871
  • Reassigned Medicare billing, New Jersey enrollment
  • Medicare enrollment name: Northwest Optometry Group PA
  • 9 clinicians in this Medicare group
NPI 1801853254 (973) 729-9199

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

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
132 services132 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
40 services38 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
35 services32 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
24 services24 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
21 services21 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
17 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07871 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
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 4

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

DR. ERNEST MICHAEL STAEHLE O.D.
Optometrist
117 SPARTA AVE
SPARTA, NJ 07871
Sussex County (215) 873-7826
KAREN CHEN OD
Optometrist
117 SPARTA AVE
SPARTA, NJ 07871
Sussex County (973) 729-9199
NORTHWEST OPTOMETRY GROUP, P.A.
Optometrist
117 SPARTA AVE
SPARTA, NJ 07871
Sussex County (973) 729-9199
DR. JEFFREY F. CLAUSS O.D.
Optometrist
117 SPARTA AVE
SPARTA, NJ 07871
Sussex County (973) 729-9199

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 Elena Martinez's NPI number?

The NPI number for Elena Martinez is 1093166290. It was assigned to this individual provider in the NPPES registry on June 29, 2016.

Where is Elena Martinez located?

Elena Martinez practices at 117 Sparta Ave, Sparta, NJ 07871. The listed phone number is (973) 726-0669.

What is Elena Martinez's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Elena Martinez enrolled in Medicare?

Yes. Elena Martinez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Elena Martinez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elena Martinez reassigns Medicare benefits to Northwest Optometry Group, P.A. (Sparta, 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 Elena Martinez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elena Martinez accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Oscar Health and 7 other insurers list Elena 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 Elena Martinez was last updated on June 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.