1. Home
  2. Directory
  3. Montana
  4. Great Falls
  5. Family Medicine
  6. NPI Profile

RAFAEL MARTINEZ
NPI 1508286451
Family Medicine in Great Falls, MT

Active since April 18, 2014PECOS EnrolledAccepts Medicare Assignment
1101 26TH ST S, GREAT FALLS, MT 59405(406) 731-8888(406) 731-8876 Get Directions Write a Review

NPPES record last updated: April 28, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 26, 2018, Jun 19, 2017, Apr 21, 2017 (3 updates tracked since 2017).

About Rafael Martinez NPPES

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

RAFAEL MARTINEZ (NPI 1508286451) is an individual family medicine provider in Great Falls, Montana, licensed in Montana (52575) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with St James Healthcare, and is a graduate of Nova Southeastern College Of Osteo Medicine (2014).

NPPES Registry Identity

NPI1508286451
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRAFAEL MARTINEZ
Location Address1101 26TH ST SGreat Falls, MT 59405
Mailing Address1101 26th St SGreat Falls, MT 59405 · (406) 731-8888 · Fax (406) 731-8876
Phone(406) 731-8888
Fax(406) 731-8876
Sole ProprietorNo
Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 2014
Enumeration DateApril 18, 2014
Last NPPES UpdateApril 28, 20203 updates tracked since enumeration
NPPES CertifiedApril 28, 2020
✔ NPI 1508286451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MT · 52575
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 04558 (KY)
Also ListedHospitalistTaxonomy 208M00000X · License 52575 (MT)
1101 26TH ST S, Great Falls, MT 59405
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Texas, Mountain Health CO-OP 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

Rafael Martinez 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 ID244516466
PECOS Enrollment IDI20170424000978, I20240109004262
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

9

Medicare enrollment records show Rafael Martinez reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Benefis Hospitals, Inc.
0.1 mi
General Acute Care Hospital
1101 26TH ST S
Great Falls, MT 59405
  • Reassigned Medicare billing, Montana enrollment
  • 637 clinicians in this Medicare group
NPI 1881650737 (406) 455-5000
Cmsc, LLC
0.4 mi
General Acute Care Hospital
3010 15TH AVE S
Great Falls, MT 59405
  • Reassigned Medicare billing, Montana enrollment
  • 163 clinicians in this Medicare group
NPI 1639109978 (406) 216-8000
Scl Health Medical Group-Butte LLC
96 mi
Rural Health
214 S MAIN ST
Boulder, MT 59632
  • Reassigned Medicare billing, Montana enrollment
  • 278 clinicians in this Medicare group
NPI 1861031122 (406) 225-4201
Concord Medical Group Of Texas PLLC
1,078 mi
Emergency Medicine
1602 AVENUE Q
Lubbock, TX 79401
  • Reassigned Medicare billing, Texas enrollment
  • 1,439 clinicians in this Medicare group
NPI 1750790762 (888) 264-0330
Emergency Professionals Of Indiana, P.C.
1,358 mi
Emergency Medicine
7950 W JEFFERSON BLVD
Fort Wayne, IN 46804
  • Reassigned Medicare billing, Indiana enrollment
  • Medicare enrollment name: Emergency Professionals Of Indiana PC
  • 404 clinicians in this Medicare group
NPI 1013951219 (260) 435-2699
Methodist Health, Inc.
1,363 mi
Rural Health
1284 US HIGHWAY 60 W
Morganfield, KY 42437
  • Reassigned Medicare billing, Kentucky enrollment
  • Also billed through NPI 1689232258 (Kentucky)
  • 125 clinicians in this Medicare group
NPI 1548248123 (270) 389-2323
Travis County Emergency Physicians PA
1,387 mi
Emergency Medicine
1201 W 38TH ST
Austin, TX 78705
  • Reassigned Medicare billing, Texas enrollment
  • 1,511 clinicians in this Medicare group
NPI 1962440933 (330) 493-4443
Third Coast Emergency Physicians Southwest PA
1,420 mi
Emergency Medicine
4103 NORTH LOOK 1604 W
San Antonio, TX 78249
  • Reassigned Medicare billing, Texas enrollment
  • 379 clinicians in this Medicare group
NPI 1497793475 (330) 493-4443
Concord Company Of Tennessee PLLC
1,442 mi
Emergency Medicine
910 WALLACE AVE
Leitchfield, KY 42754
  • Reassigned Medicare billing, Kentucky enrollment
  • 107 clinicians in this Medicare group
NPI 1649743667 (270) 256-9400

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 5

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
66 services48 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.
46 services40 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
44 services41 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.
40 services38 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
23 services13 patients

Hospital Affiliations CMS Care Compare 4

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

St James Healthcare

Acute Care Hospitals · Butte, MT
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270017
Location400 S Clark StButte, MT 59701 · Silver Bow County
Emergency services Birthing friendly

Baptist Medical Center

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450058
Location111 Dallas StreetSan Antonio, TX 78205 · Bexar County
Emergency services Birthing friendly

Frio Regional Hospital

Critical Access Hospitals · Pearsall, TX
OwnershipVoluntary non-profit - Private
CMS Certification Number451391
Location200 S Ih 35Pearsall, TX 78061 · Frio County
Emergency services

Baptist Neighborhood Hospital Thousand Oaks

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number670078
Location16088 San PedroSan Antonio, TX 78232 · Bexar County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59405 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
$87.97 typical visit price
range $56.81 – $172.26
Typical copayment $21.99 (range $14.20 – $43.06)
Most-billed visit code 99203
Established Patient
$100.16 typical visit price
range $18.24 – $140.32
Typical copayment $25.04 (range $4.56 – $35.08)
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.

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.

OMER USMAN MD
Hospitalist
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 455-5000
EDMUND J BRENNAN MD
Internal Medicine (Clinical Cardiac Electrophysiology)
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 731-8888
MRS. DELENE R LYNES OTA
Occupational Therapy Assistant
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 455-5412
SHELBY ELIZABETH DUFOUR PHARMD
Pharmacist
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 771-6300
DANIEL KNUFFKE
Occupational Therapist
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 781-1305
KRISTIN HUNTOON D.O, PHD
Neurological Surgery
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 455-5000
PATRICK HUGH SMITH FNP-BC
Nurse Practitioner (Family)
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 455-5000
DR. SAMANTHA ANNE BASCO PHARMD
Pharmacist
1101 26TH ST S
GREAT FALLS, MT 59405
Cascade County (406) 455-5430

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 Rafael Martinez's NPI number?

The NPI number for Rafael Martinez is 1508286451. It was assigned to this individual provider in the NPPES registry on April 18, 2014.

Where is Rafael Martinez located?

Rafael Martinez practices at 1101 26th St S, Great Falls, MT 59405. The listed phone number is (406) 731-8888.

What is Rafael Martinez's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Rafael Martinez enrolled in Medicare?

Yes. Rafael 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 organizations bill Medicare for Rafael Martinez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rafael Martinez reassigns Medicare benefits to 9 organizations: Benefis Hospitals, Inc. (Great Falls, MT), Cmsc, LLC (Great Falls, MT), Scl Health Medical Group-Butte LLC (Boulder, MT), Concord Medical Group Of Texas PLLC (Lubbock, TX), Emergency Professionals Of Indiana, P.C. (Fort Wayne, IN) and 4 more organizations, listed in the Medicare section above. 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 Rafael Martinez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rafael Martinez accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Texas, Mountain Health CO-OP and Sendero Health Plans, Local Nonprofit list Rafael 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 Rafael Martinez affiliated with any hospitals?

According to CMS data, Rafael Martinez is affiliated with St James Healthcare, Baptist Medical Center, Frio Regional Hospital and Baptist Neighborhood Hospital Thousand Oaks.

When was this NPI record last updated?

The NPPES record for Rafael Martinez was last updated on April 28, 2020. 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.