DR. DANIEL B MARTINEZ M.D.
NPI 1194896878
Psychiatry & Neurology - Child & Adolescent Psychiatry in Lombard, IL
NPI Status: Active since November 13, 2006
Contact Information
2340 S HIGHLAND AVE
SUITE 300
LOMBARD, IL
ZIP 60148
Phone: (630) 261-1210
Fax: (630) 261-1211
- Individual
- Male
- Years of Experience 31
- Psychiatry & Neurology
- Child & Adolescent Psychiatry
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About DANIEL MARTINEZ
This page provides the complete NPI Profile along with additional information for Daniel Martinez, a provider established in Lombard, Illinois with a medical specialization in Psychiatry & Neurology, focusing in child & adolescent psychiatry and more than 31 years of experience. He graduated from Loyola University Of Chicago, Stritch School Of Medicine in 1995. The healthcare provider is registered in the NPI registry with number 1194896878 assigned on November 2006. The practitioner's primary taxonomy code is 2084P0804X with license number 036095776 (IL). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1194896878
- Provider Name
- DR. DANIEL B MARTINEZ M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2340 S HIGHLAND AVE SUITE 300 LOMBARD, IL 60148
- Location Phone
- (630) 261-1210
- Location Fax
- (630) 261-1211
- Mailing Address
- 2340 S HIGHLAND AVE SUITE 300 LOMBARD, IL 60148
- Mailing Phone
- (630) 261-1210
- Mailing Fax
- (630) 261-1211
- Medical School Name
- LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
- Graduation Year
- 1995
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-13-2006
- Last Update Date
- 01-18-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Child & Adolescent Psychiatry
- Taxonomy Code
- 2084P0804X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036095776
- License State
- IL
- Taxonomy Description
- Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 036095776 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 364390963 | OTHER (01) | IL | TAX ID |
Medicare Participation & PECOS Enrollment Status
Daniel Martinez is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Daniel Martinez is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4385633668
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20040511000975
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 30-39 minutes
Psychiatric diagnostic evaluation with medical services
Psychiatric services complicated by communication factor
Psychotherapy with evaluation and management visit, 30 minutes
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.
This service was performed 390 times for 90 patientsA psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
This service was performed 64 times for 52 patientsPsychiatric services complicated by communication factors involve mental health care for individuals who have challenges with communication. This can include language barriers, speech disorders, or cognitive impairments. The process involves tailored strategies to ensure effective communication and appropriate mental health care.
This service was performed 38 times for 18 patientsPsychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
This service was performed 394 times for 90 patientsQuality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Colorectal Cancer Screening | 1% | 103 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 18% | 341 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1194896878, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LOMBARD, IL 60148
LOMBARD, IL 60148
LOMBARD, IL 60148
LOMBARD, IL 60148
LOMBARD, IL 60148
LOMBARD, IL 60148
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194896878, enumerated as an "individual" on November 13, 2006.
The provider is located at 2340 S HIGHLAND AVE SUITE 300 LOMBARD, IL 60148 and the phone number is (630) 261-1210.
Psychiatry & Neurology with taxonomy code 2084P0804X and a focus in Child & Adolescent Psychiatry.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
