Individual provider Active NPI

Adrian P Martin, M.D.

  • Surgery Physician
  • Carbondale, IL
National Provider Identifier
1568531010
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036115702 Issued in IL
Practice address
305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone
(618) 457-3006
Fax
(618) 457-3007
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036115702 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 206
Carbondale, IL 62901-1474

Mailing address

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

Other practice location 1

317 S 14th St
Herrin, IL 62948-3671
Phone (618) 942-2002

Other identifiers 6

IdentifierTypeStateIssuer
3932056OtherILBCBS OF IL
7210895OtherILAETNA
120857OtherILHEALTH ALLIANCE
324137OtherILGHP
036115702MedicaidIL
294010OtherILHEALTHLINK

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmartin13576@sih.direct-ci.com
Direct Messaging Address mmartin13576@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061211000157 IL Practitioner - General Surgery 9133128697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

305 W Jackson St
Carbondale, IL 62901-1474

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)27
Upper gastrointestinal (GI) endoscopy for acid reflux14
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036115702ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Nov 19, 2007 Accepting new patients
Southern Illinois Hospital Services Past Accepting new patients
Southern Illinois Medical Services, NFP PastSince Jan 1, 2021 Accepting new patients

Locations

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

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

305 W Jackson St
Ste 300
Carbondale, IL 62901
Phone (618) 457-3006

317 S 14th St
Herrin, IL 62948
Phone (618) 942-2002

Interoperability endpoints

  • Direct secure messaging: mmartin13576@sih.direct-ci.com

Organizations & group practices 3

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 4

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1568531010",
    "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": "305 W JACKSON ST STE 206",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483671",
            "country_code": "US",
            "telephone_number": "618-942-2002",
            "fax_number": "618-988-9780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ADRIAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036115702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "3932056",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7210895",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "120857",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "324137",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115702",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "294010",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartin13576@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartin13576@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "317 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.