NPIMap

Individual provider Active NPI

Erin Martin, MD

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1457573818
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036122198 Issued in IL
Practice address
815 Main St
Peoria, IL 61602-1076
Phone
(309) 672-4977
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036122198 IL Primary

Addresses

Primary practice location

815 Main St
Peoria, IL 61602-1076

Mailing address

5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000508 IL Practitioner - Family Practice 9032249586 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

158 E Fulton St
Farmington, IL 61531-1227
Phone (309) 245-2416

5401 N Knoxville Ave
Peoria, IL 61614-5021

61 E Side SQ
Canton, IL 61520-2603
Phone (309) 649-1572

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 22, 2009 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 22, 2009 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Mar 1, 2023 Accepting new patients

Locations

2076 N Main St
Canton, IL 61520
Phone (309) 647-6090

5100 Reliable Pkwy
Chicago, IL 60686
Phone (309) 672-4809

158 E Fulton St
Farmington, IL 61531
Phone (309) 245-2416

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Peoria, IL 61602
Phone (309) 672-4908

815 Main St
Ste A1
Peoria, IL 61602

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: emartinmd388510@carlehiedirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Farmington Village Nursing and Rehabilitation CenterFarmington, IL, CCN 145404 Skilled nursing facility Adp of the SNF May 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 9

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1457573818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "309-672-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021076",
            "telephone_number": "309-672-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ERIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036122198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.