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Marta Lucia Miguelena, MD

Family Practice · San Jose

NPI 1598344251

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
7
3 carriers
Offices
2

Offices

2 locations · University Healthcare Alliance · Indian Health Center of Santa Clara Valley

Looking this up.

Hospitals listed: Santa Clara Valley Medical Center · Stanford Health Care. That is not proof they admit you there this week.

Plans that list them

7 plans · 3 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Miguelena’s office at (408) 995-5453 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

7 of 7 plans

Plans whose provider directory lists this clinician
Anthem Full Dual Advantage Aligned (HMO D-SNP)Anthem Blue CrossListedOct 3, 2026
Anthem Medicare Advantage (HMO-POS)Anthem Blue CrossListedOct 3, 2026
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
DualConnect (HMO D-SNP)Santa Clara Family Health PlanListedSep 1, 2026

Hospitals they work in

2 hospitals

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend it
    Overall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
  • Stanford Health CareStanford, CAAcute Care Hospital · Voluntary non-profit - Private · Has an emergency departmentPart of Stanford Health Care, which runs 3 hospitalsHome of Stanford Cancer Institute, a National Cancer Institute designated comprehensive cancer centrePatients rate it 4 of 5 · 83% would definitely recommend it
    Overall rating: 5 of 5 starsWorse than the national rate — Perioperative pulmonary embolism or deep vein thrombosis rate: 5.31 (4.24 to 6.37) · 8,661 cases, Jul 2022 – Jun 2024Worse than the national rate — Rate of inpatient admissions for patients receiving outpatient chemotherapy: 14.1 (12.7 to 15.7) · 2,191 cases, Jan 2024 – Dec 2024Better than the national rate — Postoperative respiratory failure rate: 4.08 (1.95 to 6.21) · 5,296 cases, Jul 2022 – Jun 2024Better than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0.317, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.446, Oct 2024 – Sep 2025Better than the national rate — SSI - Colon Surgery: 0.241, Oct 2024 – Sep 2025Better than the national rate — Ratio of unplanned hospital visits after hospital outpatient surgery: 0.7 (0.6 to 0.9) · 3,348 cases, Jan 2024 – Dec 2024
See every measure and the patient survey for Santa Clara Valley Medical Center

Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Santa Clara Valley Medical Center
SSI - Colon SurgeryInfections2.572WorseOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.563BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.256BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0.369BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.25 (0.3 to 2.2) · 1,535 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.07 (0.76 to 1.38)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths214.59 (167.38 to 261.8) · 108 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.8 · 41 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6 · 141 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths10.2 · 124 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.3 · 501 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths14.9 · 653 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths10.1 · 348 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3 · 4,502 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.04 to 0.43) · 9,014 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.34 (0.15 to 0.52) · 9,216 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.54 (2.51 to 6.58) · 1,421 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.54 (0 to 3.2) · 288 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.66 to 3.56) · 1,446 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths11.61 (4.09 to 19.14) · 294 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths7.29 (3.39 to 11.2) · 299 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.9 (0.45 to 3.36) · 333 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.23 (0 to 0.78) · 7,538 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths5.4 · 94 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.735No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections2.573No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits14.6 · 185 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.1 · 951 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits56.3 · 128 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits6.4 · 644 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits1.3 · 699 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.3 · 921 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.7 (3.9 to 8.1) · 226 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits12.6 (9.4 to 16.5) · 226 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.4 · 94 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits11.4 · 54 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 242 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits13.2 (9.9 to 17.4) · 702 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits1 (0.7 to 1.4) · 195 casesNo differentJan 2024 – Dec 2024

What patients said (4,032 patients answered, 29% of those asked)

Patient survey stars by topic at Santa Clara Valley Medical Center
Cleanliness3
Nurse communication3
Doctor communication3
Communication about medicines3
Discharge information2
Overall hospital rating3
Quietness2
Recommend hospital4
Share of patients giving the best answer at Santa Clara Valley Medical Center
Room was "always" clean70%
Nurses "always" communicated well73%
Doctors "always" communicated well76%
Staff "always" explained57%
Yes, staff "did" give patients this information82%
Yes, staff "did" give patients information about help after discharge82%
Doctors "always" explained things so they could understand71%
Doctors "always" listened carefully74%
Doctors "always" treated them with courtesy and respect82%
Patients who gave a rating of "9" or "10" (high)67%
Staff "always" explained new medications71%
Nurses "always" explained things so they could understand71%
Nurses "always" listened carefully69%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night43%
"YES", patients would definitely recommend the hospital70%
Staff "always" explained possible side effects44%
Yes, staff "did" give patients information about possible symptoms83%
See every measure and the patient survey for Stanford Health Care

Behind the star rating — Deaths: 5 better, 3 the same, 0 worse of 8 measures. Safety: 3 better, 5 the same, 0 worse of 8 measures. Readmissions: 2 better, 5 the same, 4 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Stanford Health Care
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths5.31 (4.24 to 6.37) · 8,661 casesWorseJul 2022 – Jun 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits14.1 (12.7 to 15.7) · 2,191 casesWorseJan 2024 – Dec 2024
Postoperative respiratory failure rateComplications and deaths4.08 (1.95 to 6.21) · 5,296 casesBetterJul 2022 – Jun 2024
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.317BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.446BetterOct 2024 – Sep 2025
SSI - Colon SurgeryInfections0.241BetterOct 2024 – Sep 2025
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits0.7 (0.6 to 0.9) · 3,348 casesBetterJan 2024 – Dec 2024
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.06 (0.45 to 1.67) · 5,374 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths0.86 (0.72 to 1)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths166.09 (137.88 to 194.3) · 470 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths1.1 · 192 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6.4 · 146 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths9.7 · 253 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths6.3 · 880 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths10.3 · 935 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths8.7 · 501 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths2.1 · 7,730 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.13 (0 to 0.27) · 20,799 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.28 (0.14 to 0.43) · 23,182 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths0.94 (0.2 to 1.68) · 5,694 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.36 (1.54 to 3.19) · 7,846 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths5.2 (3.76 to 6.64) · 5,603 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.38 (0.23 to 2.53) · 2,211 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.52 (0.21 to 0.83) · 19,915 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths3.6 · 416 casesNoneApr 2023 – Mar 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.869No differentOct 2024 – Sep 2025
MRSA BacteremiaInfections0.857No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections0.368No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits16.2 · 247 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits20.5 · 1,021 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits47.8 · 258 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits-1.6 · 990 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits20.8 · 976 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.5 · 959 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.2 (4.4 to 6.2) · 2,191 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.1 · 425 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits9.6 · 158 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits19.6 · 183 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits12.7 (10.4 to 15.4) · 4,578 casesNo differentJan 2022 – Dec 2024

What patients said (6,810 patients answered, 25% of those asked)

Patient survey stars by topic at Stanford Health Care
Cleanliness4
Nurse communication4
Doctor communication4
Communication about medicines3
Discharge information4
Overall hospital rating4
Quietness2
Recommend hospital5
Share of patients giving the best answer at Stanford Health Care
Room was "always" clean75%
Nurses "always" communicated well82%
Doctors "always" communicated well81%
Staff "always" explained63%
Yes, staff "did" give patients this information89%
Yes, staff "did" give patients information about help after discharge89%
Doctors "always" explained things so they could understand76%
Doctors "always" listened carefully80%
Doctors "always" treated them with courtesy and respect87%
Patients who gave a rating of "9" or "10" (high)79%
Staff "always" explained new medications76%
Nurses "always" explained things so they could understand77%
Nurses "always" listened carefully79%
Nurses "always" treated them with courtesy and respect88%
"Always" quiet at night53%
"YES", patients would definitely recommend the hospital83%
Staff "always" explained possible side effects50%
Yes, staff "did" give patients information about possible symptoms90%

Original Medicare doctor bills

$5,030

Medicare paid this office $5,030 for 20 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Procedures Medicare counted

Procedure volume Medicare published
Skin biopsy1-10None

Who their Medicare patients are

20 Original Medicare patients in 2024. Average age 76 · Health risk score 2.40. Sicker patients than 9 in 10 peers; the typical family practice clinician is at 1.13.

Conditions among them: High blood pressure 75%.

The office billed $20,562, Medicare allowed $6,313 and paid $5,030; for 60 services of 11 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Medicaid work

$2,255 in 2024

Medicaid paid $2,255 for 99 billed services this clinician did in 2024, up to 18 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES69$1,433
1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES15$506
Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter15$316
Medicaid work by year
202499318$2,255
202344117$10,620
202291241$15,104
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Clinic visit/encounter, all-inclusive44$10,620

2022

Largest Medicaid services in 2022
Clinic visit/encounter, all-inclusive62$15,104
Short return visit (20+ min)29$0

Drugs they prescribed that Part D paid

$55,019

Pharmacies billed $55,019 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

327 generic and fewer than 11 brand-name prescriptions · $55,019 in drug cost · 12 antibiotic prescriptions to 11 people.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Jardiance20$16,585$829
Albuterol Sulfate Hfa11$335$30
Famotidine14$186$13
Pravastatin12$144$12
Metformin25$142$6
See all 9 drugs
Every Part D drug this clinician prescribed
Jardiance20$16,585$829
Albuterol Sulfate Hfa11$335$30
Famotidine14$186$13
Pravastatin12$144$12
Metformin25$142$6
Amlodipine Besylate26$102$4
Atorvastatin17$99$6
Losartan17$94$6
Lisinopril15$90$6

Year by year

Part D prescribing by year
2024416104NoneNone$55,019
2023540103None18%$77,441
202219849NoneNone$21,072

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 11 drugs

Part D drugs prescribed in 2023
Jardiance25$27,635$1,105
Lidocaine15$1,409$94
Atorvastatin29$1,079$37
Amlodipine Besylate25$602$24
Famotidine18$410$23
Metformin26$376$14
Lisinopril23$363$16
Rosuvastatin16$342$21
Losartan25$332$13
Omeprazole20$218$11
Clopidogrel11$206$19

2022: 3 drugs

Part D drugs prescribed in 2022
Metformin12$159$13
Atorvastatin14$123$9
Lisinopril12$111$9

Professional record

NPI
1598344251
Trained
University of California, Davis School of Medicine, 2021
Group
University Healthcare Alliance · Indian Health Center of Santa Clara Valley
Video visits
Lists video visits
Gender
Female
More record details
Sole proprietor
No
Taxonomy
Family medicine (207Q00000X)
Mailing address
455 Oconnor Dr Ste 250, San Jose, CA, 95128
NPI first listed
2021-04-07
NPI last updated
2025-06-05
NPI record certified
2025-06-05

This is when the NPI record was last certified, not a medical board exam.

Extra NPI addresses: 1333 Meridian Ave, San Jose, CA, 95125 · 1642 E Capitol Expy, San Jose, CA, 95121 · 2039 Forest Ave, San Jose, CA, 95128