Individual provider Active NPI

Jennifer L Martens, FNP

  • Family Nurse Practitioner
  • O'Fallon, IL
National Provider Identifier
1336659523
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209016645 Issued in IL
Practice address
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone
(618) 234-2120
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209016645 IL Primary

Addresses

Primary practice location

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099

Mailing address

105 Riggs PL
Saint Charles, MO 63301-8490
Phone (314) 348-8436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171120002437 IL Practitioner - Nurse Practitioner 7416214846 Reassigns benefits to 1 organization
I20180618001701 MO Practitioner - Nurse Practitioner 7416214846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-4450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209016645ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Illinois Hospitalists CurrentSince Jul 26, 2019 Accepting new patients
Southeastern Physician Services PC CurrentSince Jul 1, 2025 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients
Cep America-Illinois Hospitalists, LLP CurrentSince Jul 26, 2019 Accepting new patients
Fairview Heights Medical Group SC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1336659523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RIGGS PL",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633018490",
            "telephone_number": "314-348-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.