Rebecca Lynn Martin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003480 Issued in IL

Practice address

176 W Mound Rd
Decatur, IL 62526-1964

Phone

(217) 875-0163

NPI assigned

Jul 3, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rebecca.martin.p31@direct.fhn-fqhc.nextgenshare.com
• Direct secure messaging: rmartin238514@ewd.direct.hshs.org

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.

• HSHS Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1962644807
  Medicare reassignment NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD
• Community Health Improvement Center

  • Federally Qualified Health Center (FQHC)
  • Decatur, IL
  • NPI 1194794917
  NPD (past)

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1841429495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 W MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261964",
            "telephone_number": "217-875-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 W MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261964",
            "telephone_number": "217-875-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-03",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmartin238514@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "176 W Mound Rd",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625261964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie Ann Marsh
• Marshall F. Brustein M.D.
• Gloria J Marshall
• Amy E Marsili, L.C.S.W.
• Lakyla Martin
• Roberta Jo Martin, PHARMD
• Susan K Martin
• Amanda Martz
• Angie Mason, RBT
• Anita F Mason, MA; LMFT

• Physician Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.