Individual provider Active NPI

Pamela Marteykuor Martey, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1528417136
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125068867 Issued in IL
Practice address
1900 West Polk Street
RM 1134 Administration Building
Chicago, IL 60612
Phone
(312) 864-9717
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125068867 IL Primary

Addresses

Primary practice location

1900 West Polk Street
RM 1134 Administration Building
Chicago, IL 60612

Mailing address

1969 W Ogden Ave
Department of Pediatrics John H Stroger Jr Hospital of
Chicago, IL 60612-3765
Phone (312) 864-6000

Other names 1

  • Ms. Pamela Marteykuor Martey Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pbotchway@direct.ccprovider.org Direct Cook County

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
I20190730004332 IL Practitioner - Pediatric Medicine 3476847807 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125068867ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 17, 2022 Accepting new patients
Cook County CurrentSince Jul 19, 2019 Accepting new patients
Cook County Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Pediatrics CurrentSince Jul 19, 2019 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Jan 17, 2022 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1900 W Polk St
Rm 1134
Chicago, IL 60612
Phone (312) 864-4505

1969 W Ogden Ave
#H
Chicago, IL 60612

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

Interoperability endpoints

  • Direct secure messaging: pbotchway@direct.ccprovider.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1528417136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1969 W OGDEN AVE",
            "address_2": "DEPARTMENT OF PEDIATRICS JOHN H STROGER JR HOSPITAL OF",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123765",
            "telephone_number": "312-864-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WEST POLK STREET",
            "address_2": "RM 1134 ADMINISTRATION BUILDING",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-864-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTEY",
        "first_name": "PAMELA",
        "middle_name": "MARTEYKUOR",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125068867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbotchway@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "MARTEY",
            "middle_name": "MARTEYKUOR",
            "prefix": "MS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.