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SONIA MARTINEZ LCSW
NPI 1205628583
Social Worker - Clinical in Baytown, TX

Active since May 21, 2025PECOS EnrolledAccepts Medicare Assignment
4301 GARTH RD STE 400, BAYTOWN, TX 77521(281) 420-8400 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sonia Martinez Lcsw NPPES

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

SONIA MARTINEZ LCSW (NPI 1205628583) is an individual clinical provider in Baytown, Texas, licensed in Texas (64625) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1205628583
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSONIA MARTINEZCredential: LCSW
Location Address4301 GARTH RD STE 400Baytown, TX 77521-3159
Mailing AddressPo Box 750551Houston, TX 77275-0551 · (713) 775-9182
Phone(281) 420-8400
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateMay 21, 2025
NPPES CertifiedMay 14, 2025
✔ NPI 1205628583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in TX · 64625
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4301 GARTH RD STE 400, Baytown, TX 77521
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Sonia Martinez Lcsw 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 ID1456865583
PECOS Enrollment IDI20250709003337
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 Sonia Martinez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Legacy Community Health Services, Inc
25 mi
Federally Qualified Health Center (FQHC)
1415 CALIFORNIA ST
Houston, TX 77006
  • Reassigned Medicare billing, Texas enrollment
  • 402 clinicians in this Medicare group
NPI 1679524961 (832) 548-5000

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 77521 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
$0.00 typical visit price
range $58.24 – $176.98
Typical copayment $0.00 (range $14.56 – $44.24)
Most-billed visit code NA
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
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 6

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

DR. MADHUMITA BANGA MD
Family Medicine
4301 GARTH RD STE 400
BAYTOWN, TX 77521
Harris County (832) 548-5000
PAYEL BANIK D.O.
Family Medicine
4301 GARTH RD STE 400
BAYTOWN, TX 77521
Harris County (281) 428-4563
BETTY MERCER
Social Worker
4301 GARTH RD STE 400
BAYTOWN, TX 77521
Harris County (281) 628-2017
LEGACY COMMUNITY HEALTH SERVICES, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
4301 GARTH RD STE 400
BAYTOWN, TX 77521
Harris County (832) 548-5000
ANH TO DO
Family Medicine
4301 GARTH RD STE 400
BAYTOWN, TX 77521
Harris County (832) 548-5000
MS. SARA ANN COREY APSW
Social Worker (Clinical)
4301 GARTH RD STE 400
BAYTOWN, TX 77521
Harris County (832) 548-5000

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 Sonia Martinez's NPI number?

The NPI number for Sonia Martinez is 1205628583. It was assigned to this individual provider in the NPPES registry on May 21, 2025.

Where is Sonia Martinez located?

Sonia Martinez practices at 4301 Garth Rd Ste 400, Baytown, TX 77521. The listed phone number is (281) 420-8400.

What is Sonia Martinez's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Sonia Martinez enrolled in Medicare?

Yes. Sonia 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 Sonia Martinez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sonia Martinez reassigns Medicare benefits to Legacy Community Health Services, Inc (Houston, TX). 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 Sonia Martinez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sonia Martinez accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Sonia 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 Sonia Martinez was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.