GERALD S MARTIN (NP) – Nurse Practitioner, NPI 1770014748

GERALD S MARTIN (NP) is a healthcare provider. based in Carbondale, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 209015754 (IL). The NPI Number for GERALD S MARTIN (NP) is 1770014748

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
GERALD S MARTIN (NP)
NPI
1770014748
Phone
(618) 457-5200
Address
PO BOX 3988
Enumeration Date
22 March 2017
Last Update Date
26 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6185199200
Graduation Year
2016 (10 years ago)
PAC ID
5799060158
Group Practice PAC ID
1658285671
Professional Enrollment ID
I20170327001444
Address ID
IL629013547CA404XXLNXX400

Contacts

Secure Messaging
gmartin6968@sih.direct-ci.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Other namesUpdated within 12 months

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for GERALD S MARTIN (NP)

  • PO BOX 3988

    CARBONDALE, IL 629023988

    Phone: (618) 457-5200

    Type: Mailing

  • 98, Peach Ridge Road, Anna, Union County, Illinois, 62906, United States

    ANNA, IL 629062243

    Phone: (618) 614-1400

    Fax: (618) 614-1401

    Type: Location

  • 109 CALIFORNIA ST

    PO BOX 577

    CARTERVILLE, IL 62918

    Phone: (618) 519-9200

    Type: Mailing

  • 404 S LEWIS LN

    CARBONDALE, IL 629013547

    Phone: (618) 519-9200

    Fax: (618) 549-1288

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 43 Open Payments records for all available years, with a total value of $862.

Total Amount is formed as General ($862) + Research ($0) + Ownership ($0) = $862.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Alkermes, Inc. ($172).

Total Amount

$862

General + Research + Ownership

Payments

43

Total payment records

General Amount

$862

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-03-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170327001444INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62902)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658285671View full group profile
NameSpecialtyState
Certified Nurse Midwife (Cnm)IL
-IL
Nurse PractitionerIL
Clinical Social WorkerIL
Nurse PractitionerIL
Nurse PractitionerIL
Mental Health CounselorIL
Internal MedicineNJ
Physician AssistantIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What NPI should I save for GERALD S MARTIN (NP)?
Save NPI 1770014748 if you need a stable reference for GERALD S MARTIN (NP).
Is GERALD S MARTIN (NP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does GERALD S MARTIN (NP) list a primary specialty?
If you are matching referrals, note Nurse Practitioner for GERALD S MARTIN (NP). Clinical services aligned with this taxonomy classification.
Where is GERALD S MARTIN (NP)'s primary listing?
We display Carbondale, Illinois because that is what the record indicates for GERALD S MARTIN (NP).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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