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MICHAEL JOEL MARTINEZ M.D.
NPI 1811281140
Surgery in Mcallen, TX

Active since June 03, 2011PECOS EnrolledAccepts Medicare Assignment
53.42/100
CMS Quality Rating
533 PECAN BLVD, MCALLEN, TX 78501(956) 365-4400(956) 365-4111 Get Directions Write a Review

NPPES record last updated: June 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Nov 13, 2017, Jan 20, 2017 and 1 more (4 updates tracked since 2015).

About Michael Joel Martinez M.d. NPPES

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

MICHAEL JOEL MARTINEZ M.D. (NPI 1811281140) is an individual surgery provider in Mcallen, Texas, licensed in Texas (P5679) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Vhs Harlingen Hospital Company Llc, and maintains a secondary practice location in Harlingen.

NPPES Registry Identity

NPI1811281140
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMICHAEL JOEL MARTINEZCredential: M.D.
Location Address533 PECAN BLVDMcallen, TX 78501-2356
Mailing AddressPo Box 5358Mcallen, TX 78502-5358 · (956) 362-5673
Phone(956) 365-4400
Fax(956) 365-4111
Sole ProprietorNo
Medical School CMSYale University School Of MedicineGraduated 2009
Enumeration DateJune 3, 2011
Last NPPES UpdateJune 15, 20224 updates tracked since enumeration
NPPES CertifiedJune 15, 2022
✔ NPI 1811281140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in TX · P5679
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
533 PECAN BLVD, Mcallen, TX 78501
Open in Google Maps ↗

Secondary Practice Location 1

Location 1512 Victoria Ln Ste 2Harlingen, TX 78550-3227 · Phone (956) 365-4400 · Fax (956) 365-4111

Other Identifiers 1

Medicaid348256401TX

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Joel Martinez 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 ID7719291459
PECOS Enrollment IDI20150807015466
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 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.

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.
70 services48 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.
23 services21 patients
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235
This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
17 services17 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
12 services12 patients
Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope 43282
This procedure fixes a hernia, a bulge or tear, in the muscle where the esophagus meets the stomach. Using an endoscope, a thin tube with a camera, a mesh is implanted to strengthen the area and prevent future hernias.
11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Vhs Harlingen Hospital Company LLC

Acute Care Hospitals · Harlingen, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450033
Location2101 Pease StHarlingen, TX 78550 · Cameron County
Emergency services Birthing friendly

South Texas Health System

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450119
Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Valley Regional Medical Center

Acute Care Hospitals · Brownsville, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450662
Location100 A Alton GloorBrownsville, TX 78526 · Cameron County
Emergency services Birthing friendly

Rio Grande Regional Hospital

Acute Care Hospitals · Mcallen, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450711
Location101 E Ridge RdMcallen, TX 78503 · Hidalgo County
Emergency services Birthing friendly

Harlingen Medical Center

Acute Care Hospitals · Harlingen, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450855
Location5501 South Expressway 77Harlingen, TX 78550 · Cameron County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78501 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

53.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.29
Promoting Interoperability0
Improvement Activities0
Cost70.78

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.

LUIS GERARDO VILLEGAS PA
Physician Assistant (Medical)
533 PECAN BLVD
MCALLEN, TX 78501
Hidalgo County (956) 365-4400
ROBERT C BRACE
Podiatrist (Primary Podiatric Medicine)
533 PECAN BLVD
MCALLEN, TX 78501
Hidalgo County (956) 682-4187
JUAN J CASTANO
Internal Medicine (Gastroenterology)
533 PECAN BLVD
MCALLEN, TX 78501
Hidalgo County (956) 365-4400
DR. ROBERT C BRACE DPM
Podiatrist (Primary Podiatric Medicine)
533 PECAN BLVD
MCALLEN, TX 78501
Hidalgo County (956) 682-4187
DR. DUSTIN LUEBBERS M.D.
Colon & Rectal Surgery
533 PECAN BLVD
MCALLEN, TX 78501
Hidalgo County (956) 365-4400
VERONICA MESQUITIC
Nurse Practitioner
533 PECAN BLVD
MCALLEN, TX 78501
Hidalgo County (956) 365-4400

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 Michael Martinez's NPI number?

The NPI number for Michael Martinez is 1811281140. It was assigned to this individual provider in the NPPES registry on June 3, 2011.

Where is Michael Martinez located?

Michael Martinez practices at 533 Pecan Blvd, Mcallen, TX 78501. The listed phone number is (956) 365-4400.

What is Michael Martinez's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Michael Martinez enrolled in Medicare?

Yes. Michael 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 Michael Martinez accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Michael 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 Michael Martinez affiliated with any hospitals?

According to CMS data, Michael Martinez is affiliated with Vhs Harlingen Hospital Company LLC, South Texas Health System, Valley Regional Medical Center, Rio Grande Regional Hospital and Harlingen Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Martinez was last updated on June 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.