Individual provider Active NPI

Eduardo Martinez-Barrios, MD

  • Pulmonary Disease Physician
  • Fairview Heights, IL
National Provider Identifier
1053417238
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036114207 Issued in IL
Practice address
16 Executive Dr Ste 100
Fairview Heights, IL 62208-1366
Phone
(618) 622-9073
Fax
(618) 622-9230
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036114207 IL Primary

Addresses

Primary practice location

16 Executive Dr Ste 100
Fairview Heights, IL 62208-1366

Mailing address

16 Executive Dr Ste 100
Fairview Heights, IL 62208-1366
Phone (618) 622-9073

Other identifiers 1

IdentifierTypeStateIssuer
036114207MedicaidIL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220910000300 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8325008469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Rivers Emergency Physicians, LLC Past Accepting new patients
Fairview Heights Medical Group SC Past Accepting new patients
Healthcare Physicians of Southern Illinois, PC Pulmonary Disease Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1053417238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 EXECUTIVE DR STE 100",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081366",
            "telephone_number": "618-622-9073",
            "fax_number": "618-622-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 EXECUTIVE DR STE 100",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081366",
            "telephone_number": "618-622-9073",
            "fax_number": "618-622-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-BARRIOS",
        "first_name": "EDUARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036114207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114207",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

Verify at the official NPI Registry.