MARTIN PLAVEC M.D.
NPI 1356398093
Internal Medicine - Cardiovascular Disease in Hamden, CT

Active since May 28, 2006PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
1952 WHITNEY AVE, HAMDEN, CT 06517(203) 773-3055(203) 281-5796 Get Directions Write a Review

NPPES record last updated: October 1, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Martin Plavec M.d. NPPES

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

MARTIN PLAVEC M.D. (NPI 1356398093) is an individual cardiovascular disease provider in Hamden, Connecticut, licensed in Connecticut (038397) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1356398093
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameMARTIN PLAVECCredential: M.D.
Location Address1952 WHITNEY AVEHamden, CT 06517-1209
Mailing Address2800 Main St, St.vincent's Multispecialty GroupBridgeport, CT 06606-4201 · (203) 576-5346
Fax(203) 281-5796
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateMay 28, 2006
Last NPPES UpdateOctober 1, 2014
✔ NPI 1356398093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in CT · 038397
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X · License 038397 (CT)
1952 WHITNEY AVE, Hamden, CT 06517

Accepted 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

Martin Plavec 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 ID4385635051
PECOS Enrollment IDI20040520001375
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 Reassignments

2

Medicare enrollment records show Martin Plavec reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Adult Mental Health
95 CIRCULAR AVE
Hamden, CT 06514
  • Reassigned Medicare billing, Connecticut enrollment
  • 3,728 clinicians in this Medicare group
General Acute Care Hospital
130 DIVISION ST
Derby, CT 06418
  • Reassigned Medicare billing, Connecticut enrollment
  • 77 clinicians in this Medicare group

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 19

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
800 services647 patients
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.
671 services478 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
324 services324 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
262 services258 patients
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days 93294
This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.
139 services48 patients
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days 93296
This procedure involves remotely monitoring your pacemaker or implantable defibrillator system. Over a 90-day period, we check the device's performance and your heart's activity. This helps ensure the device is functioning properly and providing the best possible support for your heart health.
129 services48 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06517 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

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.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner (Family)
1952 WHITNEY AVE
HAMDEN, CT 06517
Internal Medicine (Cardiovascular Disease)
1952 WHITNEY AVE
HAMDEN, CT 06517
Dietitian, Registered
1952 WHITNEY AVE
HAMDEN, CT 06517
Internal Medicine
1952 WHITNEY AVE
HAMDEN, CT 06517
Physician Assistant
1952 WHITNEY AVE
HAMDEN, CT 06517
Physical Therapist
1952 WHITNEY AVE
HAMDEN, CT 06517
Internal Medicine (Cardiovascular Disease)
1952 WHITNEY AVE
HAMDEN, CT 06517
Nurse Practitioner (Family)
1952 WHITNEY AVE, 3D
HAMDEN, CT 06517

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 Martin Plavec's NPI number?

The NPI number for Martin Plavec is 1356398093. It was assigned to this individual provider in the NPPES registry on May 28, 2006.

Where is Martin Plavec located?

Martin Plavec practices at 1952 Whitney Ave, Hamden, CT 06517. The listed phone number is (203) 773-3055.

What is Martin Plavec's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Martin Plavec enrolled in Medicare?

Yes. Martin Plavec 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 organizations bill Medicare for Martin Plavec's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Martin Plavec reassigns Medicare benefits to 2 organizations: Yale University (Hamden, CT) and The Griffin Hospital (Derby, CT). Each 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 Martin Plavec's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Martin Plavec accept?

Health plans from Anthem Blue Cross and Blue Shield list Martin Plavec 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 Martin Plavec was last updated on October 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.