CARLOS O MARTINEZ M.D.
NPI 1841368933
Internal Medicine - Nephrology in Macon, GA

Active since November 30, 2006PECOS EnrolledAccepts Medicare Assignment
88.98/100
CMS Quality Rating
165 EMERY HWY, STE 100, MACON, GA 31217(478) 741-2150(478) 741-2208 Get Directions Write a Review

NPPES record last updated: May 2, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Carlos O Martinez M.d. NPPES

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

CARLOS O MARTINEZ M.D. (NPI 1841368933) is an individual nephrology provider in Macon, Georgia, licensed in Georgia (031793) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Houston Healthcare, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1841368933
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameCARLOS O MARTINEZCredential: M.D.
Location Address165 EMERY HWY, STE 100Macon, GA 31217-3666
Mailing Address165 Emery Hwy, Ste 100Macon, GA 31217-3666 · (478) 741-2150 · Fax (478) 741-2208
Fax(478) 741-2208
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateNovember 30, 2006
Last NPPES UpdateMay 2, 2024
NPPES CertifiedMay 2, 2024
NPI 1841368933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in GA · 031793
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

165 EMERY HWY, Macon, GA 31217

Other Identifiers 5

OtherCJ4042GA · Railroad Medicare Group
Other390007351GA · Railroad Medicare
Medicaid00459841MGA
Medicaid00459841NGA
Medicaid00459841UGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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

Carlos O 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 ID9133191513
PECOS Enrollment IDI20041108000802
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 15

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.
711 services357 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.
692 services160 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.
563 services330 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
478 services137 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
367 services64 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.
306 services79 patients

Hospital Affiliations CMS Care Compare 5

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

Houston Healthcare

Acute Care Hospitals · Warner Robins, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110069
Location1601 Watson BoulevardWarner Robins, GA 31093 · Houston County
Emergency services Birthing friendly

Atrium Health Navicent The Medical Center

Acute Care Hospitals · Macon, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110107
Location777 Hemlock StreetMacon, GA 31201 · Bibb County
Emergency services Birthing friendly

Fairview Park Hospital

Acute Care Hospitals · Dublin, GA
5/5 CMS rating
OwnershipProprietary
CMS Certification Number110125
Location200 Industrial BoulevardDublin, GA 31021 · Laurens County
Emergency services Birthing friendly

Coliseum Medical Centers, LLC, Dba

Acute Care Hospitals · Macon, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110164
Location350 Hospital DriveMacon, GA 31217 · Bibb County
Emergency services Birthing friendly

Bleckley Memorial Hospital

Critical Access Hospitals · Cochran, GA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number111302
Location145 Peacock StreetCochran, GA 31014 · Bleckley County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31217 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

88.98/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality95.06
Improvement Activities40
Cost44.18

Referred Medical Equipment & Supplies CMS DME claims 7

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
1 supplier11 claims11 services$21.28 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier12 claims12 services$42.33 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
1 supplier11 claims11 services$119.27 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier18 claims2,580 services$0.31 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier11 claims1,650 services$0.01 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
1 supplier11 claims11 services$18.89 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 3

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

Internal Medicine (Nephrology)
165 EMERY HWY, SUITE 100
MACON, GA 31217
Internal Medicine (Nephrology)
165 EMERY HWY, 100
MACON, GA 31217
Nurse Practitioner (Family)
165 EMERY HWY, SUITE 100
MACON, GA 31217

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 1841368933. It was assigned to this individual provider in the NPPES registry on November 30, 2006.

Where is Carlos Martinez located?

Carlos Martinez practices at 165 Emery Hwy Ste 100, Macon, GA 31217. The listed phone number is (478) 741-2150.

What is Carlos Martinez's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

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 Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer 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 Houston Healthcare, Atrium Health Navicent The Medical Center, Fairview Park Hospital, Coliseum Medical Centers, LLC, Dba and Bleckley Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Carlos Martinez was last updated on May 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.