PlainDoctor

2026 NPPES data Rheumatology Physician NPI 1366476897 M.D.
Verify on CMS →

Carlos Martinez, M.D.

Rheumatology Physician in West Seneca, New York.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 6,377 in Rheumatology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.

Federal data, no proprietary rating. We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
2K
Medicare Part D claims · 463 beneficiaries · Rheumatology Physician avg: 2K
MIPS score
94.7/100
▲ 11 pts above national avg 83.5 · Exceptional
Industry payments
$2.9K
111 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Carlos Martinez, M.D. reported a CMS MIPS final score of 94.7/100 - above the 83.5 national average - and filed 1,532 Medicare Part D claims in 2024.

94.7/100
MIPS score · +11 vs avg
2K
Part D claims, 2024
Likely
board-certified (heuristic)
≥73rd
pct among measured MIPS (lower-bound band)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.

Federal trust snapshot

What official records show about Carlos Martinez, M.D.

Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.

  • Verified

    NPI registry status

    Active listing in the CMS National Provider Identifier Registry (NPI 1366476897), first enumerated 07/10/2006.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 1,532 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.

    Source: CMS Part D Prescriber PUF

  • Reported

    CMS quality reporting (MIPS)

    Reported a CMS MIPS final score of 94.7/100 in the Quality Payment Program — a federal quality measure, not a patient review.

    Source: CMS Quality Payment Program

  • Reported

    Board certification signal

    Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.

    Source: NUCC taxonomy + CMS participation heuristic

  • Reported

    Hospital affiliations

    2 CMS Care Compare hospital affiliations on record — practice footprint from the Doctors and Clinicians file.

    Source: CMS Care Compare

  • Reported

    Industry payment transparency

    $2.9K in reported industry payments (111 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.

    Source: CMS Open Payments

  • State context

    State board disciplinary context

    New York statewide board action statistics are published annually — these figures describe aggregate state activity, not Carlos Martinez, M.D.'s individual license status. Verify directly with the state medical board.

    Source: NYSBPMC annual report 2023

  • Not in federal data

    Individual sanction lookup

    PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.

    Source: State medical board / FSMB

This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.

CMS NPPES provider registry desk

NPI 1366476897 · Rheumatology Physician

NPI-10 · ENUM-LEGACY · TAX-MID · MIPS-ELITE · RX-MID · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1366476897
  • ENUM-LEGACY 2006
  • TAX-MID 6K Rheumatology Physician
  • MIPS-ELITE 94.7/100
  • RX-MID 1,532
  • BOOK-THIN 467 in New York
  • PHOTO-FINISH Natalie Braggs · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Carlos Martinez, M.D.'s MIPS score vs every measured U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.

95 ≥ 73rd percentile 73% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). Below this entry. 80–90: 129,887 measured providers (29%). Below this entry. 90+: 189,403 measured providers (42%). This entry sits in this band. This provider 0 100 every measured MIPS clinician, bucketed by value

Each bar is a band; taller bars hold more measured providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Carlos Martinez, M.D. sits

This provider among rheumatology physician peers

Across the 1,970 rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Carlos Martinez, M.D. writes more Part D claims than 43% of them and scores higher on MIPS quality than 75% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.949.974.899.8Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 52Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 5Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 25Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 88Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 65Carlos Martinez, M.D., Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 75
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one rheumatology physician peer from a representative sample of 60; the gold marker is Carlos Martinez, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Carlos Martinez, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about Carlos Martinez, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 07/10/2006

NPI 1366476897

Primary specialty

Rheumatology Physician

Mid-sized

6,377 US NPIs in this specialty

Medicare Part D claims

1,532 26% vs specialty avg

2024 prescription claims

Specialty avg: 2,058

MIPS final score

94.7/100 11.2 pts vs avg

Exceptional band

vs 83.5 national avg

Specialty distribution in New York

How Rheumatology Physician compares to other specialties among New York providers

New York providers
Student in an Organized Heal…8%Registered Nurse5.2%Clinical Social Worker4.9%Social Worker4.5%Speech-Language Pathologist4.5%Licensed Practical Nurse4.3%Rheumatology Physician0.1%
Largest specialties in New York (% of in-state providers)

Medicare quality performance, MIPS

Carlos Martinez, M.D.'s 2023 MIPS final score plotted against the Rheumatology Physician national average

High performer (top quartile)
MIPS Final Score
94.7/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%94.7%
MIPS final score (Rheumatology Physician) - 94.7/100 vs national avg 83.5
How MIPS and board certification work

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

Practice Address

2291 UNION RD
West Seneca, NY 14224
(716) 668-6146

Provider Details

NPI 1366476897
Specialty Rheumatology Physician
Credentials M.D.
Gender Male
NPI Issued 07/10/2006

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

94.7459
Final Score
Measured-score avg: 83.5
85.8196
Quality
100
Cost
96
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Carlos Martinez, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

Carlos L Martinez MD PC
West Seneca, NY
Preferred Physician Care PC
Williamsville, NY

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Industry payments received (2024) - CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Carlos Martinez, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$2.9K

Largest payer

ABBVIE INC.

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

License & disciplinary context - New York NYSBPMC 2023 annual report

Aggregate state board data only, NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~100K New York medical licensees in 2023 - they are NOT specific to Carlos Martinez, M.D.. To verify Carlos Martinez, M.D.'s current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2024.

1,532
Total Claims
$641K
Total Drug Cost
463
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
2,150.6
Total Day Supply
61,892
Generic Drug Cost
$26K
Opioid Claims
123 (8.0% rate)
Antibiotic Claims
22

Patient Demographics

Average Patient Age
71.7 years
Avg HCC Risk Score
1.45
Gender Split
70% female / 30% male
Age Distribution
<65: 67, 65-74: 227, 75-84: 139, 85+: 30

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What Carlos Martinez, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Prednisone
 193
Methotrexate
Methotrexate Sodium
158
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
119
Celecoxib
 112
Leflunomide
 86
Tizanidine Hcl
 70
Hydroxychloroquine Sulfate
 48
Duloxetine Hcl
 47
Sulfasalazine Dr
Sulfasalazine
35
Allopurinol
 34

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

More Rheumatology Physician in NY → All providers in New York → Compare specialties →

Rheumatology Physician Overview

How Carlos Martinez, M.D. fits within the Rheumatology Physician landscape nationally.

6,377
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,058
Avg Claims per Provider

Carlos Martinez, M.D.'s 1,532 claims are below the specialty average of 2,058.

Nationwide Rheumatology Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Martinez, both outside New York so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (94.7 here).

Lama Hashish 94.8 TX Natalie Braggs 94.7 TN Melinda Garcia-Rosell 94.7 TN Manoj Kohli 94.6 IL

Same NPPES enumeration year (2006)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Richard Jimenez Bothell, WA Allen Anandarajah Indianapolis, IN Teresa Klich-Nowak Northampton, MA Lin Brown Lebanon, NH

Nearby Rheumatology Physician Providers in New York

Other clinicians with the same primary specialty enrolled in New York, drawn from the same CMS NPPES roster as Martinez.

One of 467 Rheumatology Physician providers enrolled in New York, 5 are shown here.

Dr. Mary Abdulky
MD
Syracuse, NY
Dr. Ilana Abeles
M.D., PHD
Rochester, NY
Dr. Jihad Abialmouna
M.D.
West Amherst, NY
Dr. Omar Abialmouna
MD
Buffalo, NY
Dr. Irina Abramova
D.O
New Hyde Park, NY

Compare Rheumatology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is Carlos Martinez, M.D.'s specialty? ▼
Carlos Martinez, M.D. specializes in Rheumatology Physician and practices in West Seneca, New York. Credentials: M.D..
How much does Carlos Martinez, M.D. prescribe under Medicare Part D? ▼
In 2024, Carlos Martinez, M.D. wrote 1,532 Medicare Part D claims totaling $641K in drug costs for 463 beneficiaries.
What is Carlos Martinez, M.D.'s Medicare quality score? ▼
Carlos Martinez, M.D. has a CMS MIPS Final Score of 94.7/100 (Quality: 85.8, Cost: 100). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Carlos Martinez, M.D. located? ▼
Carlos Martinez, M.D. is located at 2291 UNION RD, West Seneca, NY, 14224. Phone: (716) 668-6146.
What is Carlos Martinez, M.D.'s NPI number? ▼
Carlos Martinez, M.D.'s National Provider Identifier (NPI) is 1366476897, issued on 07/10/2006.
Does Carlos Martinez, M.D. prescribe opioids? ▼
Yes, Carlos Martinez, M.D. had 123 opioid claims in 2024 with an opioid prescribing rate of 8.0%.
How many Rheumatology Physician providers are there in the US? ▼
There are 6,377 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,058 Medicare Part D claims per year.
What drugs does Carlos Martinez, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, Carlos Martinez, M.D.'s most frequently prescribed drugs include Prednisone, Methotrexate, Hydrocodone-Acetaminophen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carlos Martinez, M.D. accept Medicare? ▼
Carlos Martinez, M.D. appears in CMS Medicare data with 1,532 Part D claims and 463 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carlos Martinez, M.D.'s credentials? ▼
Carlos Martinez, M.D.'s NPI is 1366476897 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

View source datasets and methodology notes
Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2024). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of August 2026 (NPPES) / 2024 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology

Compiled from official public sources by the editorial process.

Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.