Martin T Phillips, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

036-104648 Issued in IL

Practice address

555 W Court St
Suite 108
Kankakee, IL 60901-3664

Phone

(888) 220-6432

Fax

(630) 654-4253

NPI assigned

Sep 22, 2005

Last updated

Dec 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious Disease

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
• Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL HMO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/1b768eee-dd17-4e01-8b1e-f5330ffd0ffa/
• Direct secure messaging: mphillips278529@direct.myadvocateaurora.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metro Infectious Disease Consultants, LLC

  dba Midc, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717
  Medicare reassignment Care Compare group NPD
• Heartland Home Infusions, Inc

  dba Hhi

  • Home Infusion Agency
  • Burr Ridge, IL
  • NPI 1447246632
  NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1669797734
  NPD
• Metro Infectious Disease Consultants LLC

  dba Midc

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• Saint Joseph Medical Center - Joliet LLC

  • General Acute Care Hospital
  • Joliet, IL
  • NPI 1760220198
  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1003802349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270844",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 108",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARTIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036-104648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420307",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-104-648",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mphillips278529@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "555 W Court St",
            "address_2": "SUITE 108",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609013664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "555 W Court St",
            "address_2": "SUITE 108",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609013664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter D. Sotiropoulos, Au.D. & Assoc, PC (The Hearing Rehabilitation Center)
• Taylor Peters
• John Terrance Peterson, DDS
• Anatasia Hoang Pham, PHARMD
• Philip G Hays MD SC
• Capri Pickett
• Joseph Benedict Pigato, M. D.
• Pinnacle Opportunities Inc (Eagle Court)
• Pinnacle Opportunities Inc (Dearborn Court)
• Pinnacle Opportunities Inc (River Court)

• Infectious Disease Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Infectious Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.