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DR. CARLOS H MARTINEZ MD
NPI 1265623458
Internal Medicine - Pulmonary Disease in Marshall, MI

Active since August 05, 2007PECOS EnrolledAccepts Medicare Assignment
92.05/100
CMS Quality Rating
103 E MANSION ST, MARSHALL, MI 49068(269) 781-2658 Get Directions Write a Review

NPPES record last updated: December 16, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 16, 2019, Nov 2, 2017 (2 updates tracked since 2017).

About Dr. Carlos H Martinez Md NPPES

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

DR. CARLOS H MARTINEZ MD (NPI 1265623458) is an individual pulmonary disease provider in Marshall, Michigan, licensed in Michigan (4301095260) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS, is affiliated with Bronson Battle Creek Hospital, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1265623458
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. CARLOS H MARTINEZCredential: MD
Location Address103 E MANSION STMarshall, MI 49068-1117
Mailing Address103 E Mansion StMarshall, MI 49068-1117 · (269) 781-2658
Phone(269) 781-2658
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateAugust 5, 2007
Last NPPES UpdateDecember 16, 20192 updates tracked since enumeration
✔ NPI 1265623458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in MI · 4301095260
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 4301095260 (MI)
Also ListedPreventive Medicine · Occupational MedicineTaxonomy 2083X0100X · License BP1-0023228 (TX)
103 E MANSION ST, Marshall, MI 49068
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Other Identifiers 1

Other2784962094Myutmb 2784962094

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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. Carlos H Martinez Md 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 ID2365699410
PECOS Enrollment IDI20120824000858
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.

Areas of Expertise CMS Part B claims 10

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 office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
172 services112 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
93 services90 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
93 services90 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
56 services54 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.
45 services42 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
42 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Bronson Battle Creek Hospital

Acute Care Hospitals · Battle Creek, MI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number230075
Location300 North AvenueBattle Creek, MI 49017 · Calhoun County
Emergency services Birthing friendly

Borgess Medical Center

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230117
Location1521 Gull RoadKalamazoo, MI 49048 · Kalamazoo County
Emergency services Birthing friendly

Oaklawn Hospital

Acute Care Hospitals · Marshall, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230217
Location200 N MadisonMarshall, MI 49068 · Calhoun County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49068 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

92.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.19
Promoting Interoperability97
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
47%316 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
41%245 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
34%41 patients2/55-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.
97%546 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
26%120 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%257 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
55%408 patients3/55-star benchmark: 97%
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…
33%415 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
39%296 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%408 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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
11%408 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
21%408 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 10

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
9 suppliers113 claims114 services$15.71 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier17 claims17 services$914.48 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
10 suppliers199 claims200 services$85.26 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
5 suppliers39 claims39 services$31.75 avg. paid by Medicare
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606
DME-Drugs Administered Through DME · category DG006N
2 suppliers15 claims900 services$6.27 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
3 suppliers11 claims1,110 services$0.10 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 5

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

MOLLY TINAY
Speech-Language Pathologist
103 E MANSION ST
MARSHALL, MI 49068
Calhoun County (269) 789-8990
REBECCA JANE ADAMS M.A. SLP
Speech-Language Pathologist
103 E MANSION ST
MARSHALL, MI 49068
Calhoun County (269) 789-8990
ALCIDES E GIL-ACOSTA M.D.
Internal Medicine (Pulmonary Disease)
103 E MANSION ST, RICKETSON BLDG
MARSHALL, MI 49068
Calhoun County (269) 781-2658
KATHERINE ANN SCHOOLEY MD
Speech-Language Pathologist
103 E MANSION ST
MARSHALL, MI 49068
Calhoun County (269) 789-8990
LILLIAN BLOSHTEIN OTR/L
Occupational Therapist (Pediatrics)
103 E MANSION ST
MARSHALL, MI 49068
Calhoun County (269) 789-8990

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 Carlos Martinez's NPI number?

The NPI number for Carlos Martinez is 1265623458. It was assigned to this individual provider in the NPPES registry on August 5, 2007.

Where is Carlos Martinez located?

Carlos Martinez practices at 103 E Mansion St, Marshall, MI 49068. The listed phone number is (269) 781-2658.

What is Carlos Martinez's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Carlos Martinez enrolled in Medicare?

Yes. Carlos 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.

What insurance does Carlos Martinez accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Carlos 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 Carlos Martinez affiliated with any hospitals?

According to CMS data, Carlos Martinez is affiliated with Bronson Battle Creek Hospital, Borgess Medical Center and Oaklawn Hospital.

When was this NPI record last updated?

The NPPES record for Carlos Martinez was last updated on December 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.