Ronald Martinez, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

550 Oaklawn Ave
East Moline, IL 61244-4030

Phone

(309) 792-1074

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southpark Psychology LTD

  • Counseling Psychologist
  • Moline, IL
  • NPI 1558470419
  Medicare reassignment Care Compare group NPD
• Advanced Cardiovascular Consultants,SC

  • Specialist
  • Moline, IL
  • NPI 1588718910
  NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457415325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 OAKLAWN AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "61244",
            "telephone_number": "309-792-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 OAKLAWN AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612444030",
            "telephone_number": "309-792-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "RONALD",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "08132008",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Leganski, M.S., CCC-SLP
• Mark Lewis
• Elaena Lindskog-Dunn
• Rebecca Magers
• Marisa Manuzza
• Stephen Edward Matheis, DC
• Mark Gordon Maxwell, R.PH.
• Jamie McCammon
• Bernadette Alston McCowan, PHARM.D
• Jacqueline Marie McKnight, PHARMD

• Counselor in East Moline, IL
• Providers in East Moline, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.