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MARTIN MARTINICKY
NPI 1417630302
Nurse Practitioner - Acute Care in Jericho, NY

Active since August 08, 2023PECOS Enrolled
61 JERICHO TPKE, JERICHO, NY 11753(516) 544-8899(516) 362-3939 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Martin Martinicky NPPES

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

MARTIN MARTINICKY (NPI 1417630302) is an individual acute care provider in Jericho, New York, licensed in New York (432741) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1417630302
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameMARTIN MARTINICKY
Location Address61 JERICHO TPKEJericho, NY 11753-1051
Mailing Address9972 66th Rd Apt 7dRego Park, NY 11374-4443 · (516) 587-1113
Phone(516) 544-8899
Fax(516) 362-3939
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 8, 2023
NPPES CertifiedJune 2, 2021
✔ NPI 1417630302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in NY · 432741
61 JERICHO TPKE, Jericho, NY 11753
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Martin Martinicky is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9436646536
PECOS Enrollment IDI20251014000330
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 Martin Martinicky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Neuro Pain Care, P.C
13 mi
Specialist
16408 65TH AVE
Fresh Meadows, NY 11365
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Neuro Pain Care PC
  • 2 clinicians in this Medicare group
NPI 1629126974 (718) 460-1111

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 11753 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Martinicky's NPI number?

The NPI number for Martin Martinicky is 1417630302. It was assigned to this individual provider in the NPPES registry on August 8, 2023.

Where is Martin Martinicky located?

Martin Martinicky practices at 61 Jericho Tpke, Jericho, NY 11753. The listed phone number is (516) 544-8899.

What is Martin Martinicky's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Martin Martinicky enrolled in Medicare?

Yes. Martin Martinicky is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Martin Martinicky's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Martin Martinicky reassigns Medicare benefits to Neuro Pain Care, P.C (Fresh Meadows, NY). 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 Martin Martinicky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Martin Martinicky was last updated on August 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.