Individual provider Active NPI

Jongjin Anne Martin, M.D.

  • Obstetrics & Gynecology Physician
  • Springfield, IL
National Provider Identifier
1730443334
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-139490 Issued in IL
Practice address
415 N 9TH St
Suite 6W100
Springfield, IL 62702-5303
Phone
(217) 545-8000
Fax
(217) 545-9217
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-139490 IL Primary

Addresses

Primary practice location

415 N 9TH St
Suite 6W100
Springfield, IL 62702-5303

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

421 N 9th St Bldg Q
Springfield, IL 62702-5317
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036139490MedicaidIL

Other names 1

  • Jongjin Thomson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jongjinthomson@siusm.allscriptsdirect.net

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
I20160729000380 IL Practitioner - Obstetrics/Gynecology 5092019265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Utah School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

415 N 9TH St
Springfield, IL 62702-5303
Phone (217) 545-5817

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-139490ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 29, 2016 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 29, 2016 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

415 N 9th St
Springfield, IL 62702
Phone (217) 545-5117

421 N 9th St
Bldg Q
Springfield, IL 62702

1100 E Lincolnshire Blvd
Ste 200
Springfield, IL 62703
Phone (217) 789-1403

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

415 N 9th St
Ste 6W100
Springfield, IL 62702
Phone (217) 545-5117

Interoperability endpoints

  • Direct secure messaging: jongjinthomson@siusm.allscriptsdirect.net

Organizations & group practices 4

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 2

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1730443334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "844-470-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "address_2": "SUITE 6W100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-9217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 N 9th St Bldg Q",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025317",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JONGJIN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-139490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036139490",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jongjinthomson@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "415 N 9th St",
            "address_2": "SUITE 6W100",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627025303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JONGJIN",
            "last_name": "THOMSON",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.