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DR. AGUSTIN MARTINEZ M.D.
NPI 1194762427
General Practice in Hialeah, FL

Active since June 02, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 10D1009427 · Waiver
89.89/100
CMS Quality Rating
250 E 49TH ST, HIALEAH, FL 33013(305) 822-6885(305) 825-9965 Get Directions Write a Review

NPPES record last updated: April 1, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Agustin Martinez M.d. NPPES

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

DR. AGUSTIN MARTINEZ M.D. (NPI 1194762427) is an individual general practice provider in Hialeah, Florida, licensed in Florida (ME82266) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through February 12, 2027, and is affiliated with Larkin Community Hospital Palm Springs Campus.

NPPES Registry Identity

NPI1194762427
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. AGUSTIN MARTINEZCredential: M.D.
Location Address250 E 49TH STHialeah, FL 33013-1855
Mailing Address1324 Sw 143rd AveMiami, FL 33184-3223 · (305) 822-6885 · Fax (305) 825-9965
Phone(305) 822-6885
Fax(305) 825-9965
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateJune 2, 2006
Last NPPES UpdateApril 1, 2013
✔ NPI 1194762427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in FL · ME82266
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X · License ME82266 (FL)
250 E 49TH ST, Hialeah, FL 33013
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Other Identifiers 1

Medicare PINE5606FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Agustin Martinez M.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 ID1850395401
PECOS Enrollment IDI20081121000408
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1009427

Agustin Martinez MD PA · Hialeah, FL
Active · expires Feb 12, 2027
CLIA Number10D1009427
Laboratory TypePhysician Office
Certificate Effective DateFebruary 13, 2025
Certificate Expiration DateFebruary 12, 2027
Laboratory DirectorAgustin Martinez MD
Laboratory Phone(305) 822-6885
Laboratory LocationAgustin Martinez MD PA250 East 49th Street, Hialeah, FL 33013
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 12

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
1,267 services218 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
797 services118 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
264 services100 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
212 services115 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
146 services75 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.
101 services42 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Larkin Community Hospital Palm Springs Campus

Acute Care Hospitals · Hialeah, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100050
Location1475 W 49th StHialeah, FL 33012 · Miami-Dade County
Emergency services

Keralty Hospital

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100284
Location2500 SW 75th AveMiami, FL 33155 · Miami-Dade County
Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality72.79
Promoting Interoperability95
Improvement Activities40

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
57%234 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
87%6,145 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
53%932 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
99%236 patients4/55-star benchmark: 100%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
86%932 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
100%108 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
5%932 patients1/55-star benchmark: 75%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
0%213 patients1/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
1%1,134 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 21

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each A4233
DME-Other DME · category DE017N
2 suppliers13 claims26 services$0.40 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers133 claims307 services$6.02 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
4 suppliers70 claims70 services$2.56 avg. paid by Medicare
Spring-powered device for lancet, each A4258
DME-Other DME · category DE000N
3 suppliers13 claims13 services$1.64 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
10 suppliers109 claims136 services$1.10 avg. paid by Medicare
Skin barrier; solid, 4 x 4 or equivalent; each A4362
DME-Orthotic Devices · category DF010N
1 supplier11 claims230 services$3.01 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

AGUSTIN MARTINEZ M D P A
Clinic/Center (Primary Care)
250 E 49TH ST
HIALEAH, FL 33013
Miami-Dade County (305) 822-6885

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 Agustin Martinez's NPI number?

The NPI number for Agustin Martinez is 1194762427. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Where is Agustin Martinez located?

Agustin Martinez practices at 250 E 49th St, Hialeah, FL 33013. The listed phone number is (305) 822-6885.

What is Agustin Martinez's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Agustin Martinez enrolled in Medicare?

Yes. Agustin 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.

Does Agustin Martinez hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1009427) is associated with this NPI, valid through February 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Agustin Martinez accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Agustin 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.

Is Agustin Martinez affiliated with any hospitals?

According to CMS data, Agustin Martinez is affiliated with Larkin Community Hospital Palm Springs Campus and Keralty Hospital.

When was this NPI record last updated?

The NPPES record for Agustin Martinez was last updated on April 1, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.