Individual provider Active NPI

Muawia Martini, M.D.

  • Interventional Cardiology Physician
  • New Lenox, IL
National Provider Identifier
1386693703
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036088791 Issued in IL
Practice address
1890 Silver Cross Blvd
Pavilion a Suite 240
New Lenox, IL 60451-9524
Phone
(815) 740-1900
Fax
(815) 725-2413
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036088791 IL
Interventional Cardiology Physician 207RI0011X 036088791 IL Primary

Addresses

Primary practice location

1890 Silver Cross Blvd
Pavilion a Suite 240
New Lenox, IL 60451-9524

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
039088791MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmartini131847@direct.edward.org
Direct Messaging Address mmartini131847@dulyhealthandcare.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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506001229 IL Practitioner - Cardiovascular Disease (Cardiology) 3274522230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 240
New Lenox, IL 60451-9528
Phone (815) 740-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting18
Leg revascularization (restoring blood flow)12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Nov 1, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Nov 1, 2016 Accepting new patients
Care Group LLC Cardiovascular Disease Past Accepting new patients
Loyola University Physician Foundation Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

301 Madison St
Ste 275
Joliet, IL 60435

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

301 Madison St
Ste 207
Joliet, IL 60435

1206 E 9th St
Lockport, IL 60441
Phone (708) 406-3328

1890 Silver Cross Blvd
Ste 375
New Lenox, IL 60451
Phone (708) 346-9533

1890 Silver Cross Blvd
Ste 240
New Lenox, IL 60451
Phone (815) 485-4469

1890 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-2802

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 7

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1386693703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "PAVILION A SUITE 240",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519524",
            "telephone_number": "815-740-1900",
            "fax_number": "815-725-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "MUAWIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036088791",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036088791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039088791",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartini131847@direct.edward.org",
            "affiliation": "N",
            "address_1": "1890 Silver Cross Blvd",
            "address_2": "Pavilion A Suite 240",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604519524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartini131847@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1890 Silver Cross Blvd",
            "address_2": "Pavilion A Suite 240",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604519524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.