RICARDO MARTINEZ MD
NPI 1033307863
Family Medicine in Addison, IL

Active since October 05, 2007PECOS EnrolledAccepts Medicare Assignment
91.35/100
CMS Quality Rating
303 W LAKE ST STE 200, ADDISON, IL 60101(331) 221-9001(331) 221-3971 Get Directions Write a Review

NPPES record last updated: May 4, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 4, 2021, Jan 13, 2016 (2 updates tracked since 2016).

About Ricardo Martinez Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICARDO MARTINEZ MD (NPI 1033307863) is an individual family medicine provider in Addison, Illinois, licensed in Illinois (036087720) and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS, is affiliated with Elmhurst Memorial Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1991).

NPPES Registry Identity

NPI1033307863
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRICARDO MARTINEZCredential: MD
Location Address303 W LAKE ST STE 200Addison, IL 60101-2500
Mailing Address4201 Winfield Rd Fl 4Warrenville, IL 60555-4025 · (331) 221-6377 · Fax (331) 221-2357
Fax(331) 221-3971
Sole ProprietorYes
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1991
Enumeration DateOctober 5, 2007
Last NPPES UpdateMay 4, 20212 updates tracked since enumeration
NPPES CertifiedMay 4, 2021
NPI 1033307863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in IL · 036087720
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
303 W LAKE ST STE 200, Addison, IL 60101

Other Identifiers 2

Medicaid036087720IL
Other08143606IL · Medicare Rr

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ricardo Martinez Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527155795
PECOS Enrollment IDI20071105000315
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
293 services160 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
148 services104 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
91 services91 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
64 services54 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
34 services34 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
31 services31 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Elmhurst Memorial Hospital

Acute Care Hospitals · Elmhurst, IL
4/5 CMS rating
OwnershipProprietary
CMS Certification Number140200
Location155 East Brush Hill RoadElmhurst, IL 60126 · Du Page County
Emergency services Birthing friendly

Edward Hospital

Acute Care Hospitals · Naperville, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140231
Location801 South WashingtonNaperville, IL 60540 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.71
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
22 suppliers95 claims297 services$6.20 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
2 suppliers21 claims21 services$2.80 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
17 suppliers58 claims89 services$1.11 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers24 claims24 services$44.59 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
1 supplier15 claims15 services$40.77 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
303 W LAKE ST STE 200
ADDISON, IL 60101
Family Medicine
303 W LAKE ST STE 200
ADDISON, IL 60101
Family Medicine
303 W LAKE ST STE 200
ADDISON, IL 60101
Nurse Practitioner
303 W LAKE ST STE 200
ADDISON, IL 60101
Internal Medicine
303 W LAKE ST STE 200
ADDISON, IL 60101
Family Medicine
303 W LAKE ST STE 200
ADDISON, IL 60101
Nurse Practitioner
303 W LAKE ST STE 200
ADDISON, IL 60101
Nurse Practitioner
303 W LAKE ST STE 200
ADDISON, IL 60101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ricardo Martinez's NPI number?

The NPI number for Ricardo Martinez is 1033307863. It was assigned to this individual provider in the NPPES registry on October 5, 2007.

Where is Ricardo Martinez located?

Ricardo Martinez practices at 303 W Lake St Ste 200, Addison, IL 60101. The listed phone number is (331) 221-9001.

What is Ricardo Martinez's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ricardo Martinez enrolled in Medicare?

Yes. Ricardo Martinez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ricardo Martinez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Ricardo Martinez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ricardo Martinez affiliated with any hospitals?

According to CMS data, Ricardo Martinez is affiliated with Elmhurst Memorial Hospital and Edward Hospital.

When was this NPI record last updated?

The NPPES record for Ricardo Martinez was last updated on May 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.