Individual provider Active NPI

Kevin Martinez

  • Family Medicine Physician
  • Naperville, IL
National Provider Identifier
1144752403
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036152478 Issued in IL
Practice address
636 Raymond Dr Ste 300
Naperville, IL 60563-9792
Phone
(630) 355-5302
Fax
(630) 778-6088
NPI assigned
Mar 28, 2017
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036152478 IL Primary

Addresses

Primary practice location

636 Raymond Dr Ste 300
Naperville, IL 60563-9792

Mailing address

636 Raymond Dr Ste 300
Naperville, IL 60563-9792
Phone (630) 355-5302

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
I20200723000263 IL Practitioner - Family Practice 4486925542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

636 Raymond Dr
Naperville, IL 60563-9789
Phone (630) 315-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036152478ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Aug 17, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 17, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

636 Raymond Dr
Naperville, IL 60563
Phone (630) 355-5302

636 Raymond Dr
Ste 200
Naperville, IL 60563
Phone (630) 355-5302

636 Raymond Dr
Ste 300
Naperville, IL 60563
Phone (630) 355-5302

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1144752403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639792",
            "telephone_number": "630-355-5302",
            "fax_number": "630-778-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639792",
            "telephone_number": "630-355-5302",
            "fax_number": "630-778-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036152478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.