Individual provider Active NPI

Gabriel A Martin, PA-C

  • Physician Assistant
  • Harrisburg, IL
National Provider Identifier
1376680462
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002604 Issued in IL
Practice address
117 E Clark St
Harrisburg, IL 62946-2702
Phone
(618) 252-8625
Fax
(618) 351-4859
NPI assigned
Jan 30, 2007
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002604 IL Primary

Addresses

Primary practice location

117 E Clark St
Harrisburg, IL 62946-2702

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

3106 Outer Dr
Marion, IL 62959-5270
Phone (618) 998-0888

Other practice location 2

1007 US Highway 45 N
Eldorado, IL 62930-3767
Phone (618) 273-7723

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address gmartin21052@sih.direct-ci.com
Direct Messaging Address gmartin21052@sih.direct-ci.com
Direct Messaging Address gmartin21052@sih.direct-ci.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070215000150 IL Practitioner - Physician Assistant 1951303270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrisburg Medical Center IncGroup PAC ID 9638083884, 19 clinicians
Harrisburg Family Practice LTDGroup PAC ID 2163491564, 18 clinicians

Practice addresses (Care Compare)

1007 US Hwy 45 N
Eldorado, IL 62930-3767
Phone (618) 273-7723

117 E Clark St
Harrisburg, IL 62946-2702

3106 Outer Dr
Marion, IL 62959-5270
Phone (618) 997-4332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.73 of 100Reported as group
Quality
90.64
Promoting interoperability
100
Improvement activities
40
Cost
68.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002604ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harrisburg Medical Center Inc Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Feb 21, 2022 Accepting new patients
Harrisburg Medical Center Inc CurrentSince Aug 1, 2018 Accepting new patients
Harrisburg Medical Center Inc Past Accepting new patients
Naeem a Qureshi PC Past Accepting new patients
Harrisburg Medical Center Inc Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1007 US Highway 45 N
Eldorado, IL 62930
Phone (618) 273-7723

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

117 E Clark St
Harrisburg, IL 62946
Phone (618) 252-8625

3106 Outer Dr
Marion, IL 62959
Phone (618) 997-4332

Interoperability endpoints

  • Direct secure messaging: gabriel.martin@hmcclinic.directbygreenway.com
  • Direct secure messaging: gabrielmartin@hbmc.allscriptsdirect.net
  • Direct secure messaging: gmartin21052@sih.direct-ci.com

Organizations & group practices 6

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 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1376680462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E CLARK ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462702",
            "telephone_number": "618-252-8625",
            "fax_number": "618-351-4859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3106 Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595270",
            "country_code": "US",
            "telephone_number": "618-998-0888",
            "fax_number": "618-351-4807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 US Highway 45 N",
            "address_purpose": "LOCATION",
            "city": "Eldorado",
            "state": "IL",
            "postal_code": "629303767",
            "country_code": "US",
            "telephone_number": "618-273-7723",
            "fax_number": "618-351-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "GABRIEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmartin21052@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3106 Outer Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmartin21052@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1007 US Highway 45 N",
            "city": "Eldorado",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629303767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmartin21052@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "117 E Clark St",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

Verify at the official NPI Registry.