DR. DEREK MARTINEZ M.D.
NPI 1043506942
Neurological Surgery in Peoria, IL

Active since June 20, 2011PECOS EnrolledAccepts Medicare Assignment
83.32/100
CMS Quality Rating
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2642 Get Directions Write a Review

NPPES record last updated: January 24, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Derek Martinez M.d. NPPES

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

DR. DEREK MARTINEZ M.D. (NPI 1043506942) is an individual neurological surgery provider in Peoria, Illinois, licensed in Illinois (125060255) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Wayne State University School Of Medicine (2011).

NPPES Registry Identity

NPI1043506942
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameDR. DEREK MARTINEZCredential: M.D.
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001
Sole ProprietorYes
Medical School CMSWayne State University School Of MedicineGraduated 2011
Enumeration DateJune 20, 2011
Last NPPES UpdateJanuary 24, 2017
NPI 1043506942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
License Licensed in IL · 125060255
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
530 NE GLEN OAK AVE, Peoria, IL 61637

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

Dr. Derek Martinez M.d. 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 ID941515316
PECOS Enrollment IDI20181025001838
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 7

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
42 services42 patients
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.
21 services20 patients
Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853
Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.
20 services14 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
16 services16 patients
Insertion of brain neurostimulator pulse device with connection to 2 or more electrode arrays 61886
This procedure involves placing a small device, called a neurostimulator, in your brain. It sends electrical impulses via 2 or more connected electrodes to specific brain areas to help control symptoms. It's a safe and common procedure.
14 services14 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130006
Location190 East Bannock StreetBoise, ID 83712 · Ada County
Emergency services Birthing friendly

St Luke's Nampa Medical Center

Acute Care Hospitals · Nampa, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130071
Location9850 West St Lukes DriveNampa, ID 83687 · Canyon County
Emergency services Birthing friendly

St Luke's Elmore Medical Center

Critical Access Hospitals · Mountain Home, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131311
Location895 North 6th EastMountain Home, ID 83647 · Elmore County
Emergency services Birthing friendly

St Luke's Mccall

Critical Access Hospitals · Mccall, ID
OwnershipProprietary
CMS Certification Number131312
Location1000 State StreetMccall, ID 83638 · Valley County
Emergency services Birthing friendly

St Luke's Wood River Medical Center

Critical Access Hospitals · Ketchum, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131323
Location100 Hospital DriveKetchum, ID 83340 · Blaine County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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.

83.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.51
Promoting Interoperability100
Improvement Activities40
Cost64.88

Other Providers at the Same Location NPPES 20

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

Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637

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 Derek Martinez's NPI number?

The NPI number for Derek Martinez is 1043506942. It was assigned to this individual provider in the NPPES registry on June 20, 2011.

Where is Derek Martinez located?

Derek Martinez practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2642.

What is Derek Martinez's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is Derek Martinez enrolled in Medicare?

Yes. Derek 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 Derek Martinez accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Derek 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 Derek Martinez affiliated with any hospitals?

According to CMS data, Derek Martinez is affiliated with St Luke's Regional Medical Center, St Luke's Nampa Medical Center, St Luke's Elmore Medical Center, St Luke's Mccall and St Luke's Wood River Medical Center.

When was this NPI record last updated?

The NPPES record for Derek Martinez was last updated on January 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.