Individual provider Active NPI

Carmen A Orellana Martinez, M.D.

  • Child & Adolescent Psychiatry Physician
  • New York, NY
National Provider Identifier
1205191988
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036-138136 Issued in IL
Practice address
109 W 27TH St RM 5S
New York, NY 10001-6208
Phone
(833) 351-8255
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 74949 TN
Psychiatry Physician 2084P0800X 036-138136 IL
Psychiatry Physician 2084P0800X 319502 NY
Child & Adolescent Psychiatry Physician 2084P0804X 036-138136 IL Primary

Addresses

Primary practice location

109 W 27TH St RM 5S
New York, NY 10001-6208

Mailing address

109 W 27TH St
New York, NY 10001-0265

Other practice location 1

315 Deaderick St Ste 1550
Nashville, TN 37238-3003
Phone (833) 351-8255

Other practice location 2

6200 Hospitality Dr Fl 1
Franklin, TN 37067-5023
Phone (833) 351-8255

Other practice location 3

250 Parkway Dr Ste 150
Lincolnshire, IL 60069-4340
Phone (833) 351-8255

Other practice location 4

206 N Randolph St Ste 2
Champaign, IL 61820-3976
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180818000026 IL Practitioner - PsychiatryPractitioner - Other (Physician) 8527206648 Reassigns benefits to 5 organizations
I20221018003050 NY Practitioner - Psychiatry 8527206648 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-138136ILMDPsychiatry Physician
74949TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Locust Street Resource Center CurrentSince Sep 15, 2018 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 27, 2018 Accepting new patients
Siu Physicians & Surgeons, Inc Psychiatry CurrentSince Aug 27, 2018 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 27, 2018 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 27, 2018 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Sep 30, 2022 Accepting new patients

Locations

320 S Locust St
Carlinville, IL 62626
Phone (217) 854-3166

206 N Randolph St
Ste 2
Champaign, IL 61820
Phone (540) 892-0910

250 Parkway Dr
Ste 150
Lincolnshire, IL 60069
Phone (847) 480-1346

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

109 W 27th St
New York, NY 10001
Phone (332) 206-6054

6200 Hospitality Dr
Fl 1
Franklin, TN 37067

315 Deaderick St
Ste 1550
Nashville, TN 37238
Phone (615) 554-3233

Organizations & group practices 8

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": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1205191988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100010265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Deaderick St Ste 1550",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372383003",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6200 Hospitality Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370675023",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Parkway Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Lincolnshire",
            "state": "IL",
            "postal_code": "600694340",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 N Randolph St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618203976",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORELLANA MARTINEZ",
        "first_name": "CARMEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "74949",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-138136",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "319502",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-138136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.