DR. PETER RAY MARTIN (MD) – Emergency Medicine Physician, NPI 1104357490

DR. PETER RAY MARTIN (MD) is a healthcare provider. based in South bend, Indiana. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 323680 (LA). The NPI Number for DR. PETER RAY MARTIN (MD) is 1104357490

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER RAY MARTIN (MD)
NPI
1104357490
Phone
(574) 536-4151
Address
715 PARK AVE
Enumeration Date
27 March 2017
Last Update Date
8 January 2021

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5745233160
Graduation Year
2017 (9 years ago)
PAC ID
1557633955
Group Practice PAC ID
8022087642
Professional Enrollment ID
I20210608002538
Address ID
IN465264810GO200XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,266 EMERGENCY MEDICINE in IN

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Provider Addresses for DR. PETER RAY MARTIN (MD)

  • 715, Park Avenue, South Bend, Saint Joseph County, Indiana, 46616, United States

    SOUTH BEND, IN 466161337

    Phone: (574) 536-4151

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $33.

Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: ABBVIE INC. ($33).

Total Amount

$33

General + Research + Ownership

Payments

1

Total payment records

General Amount

$33

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$33
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: 2021-06-08

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
I20210608002538IEmergency MedicineINTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making216207$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only161157$0
99284Emergency department visit with moderate level of medical decision making8985$0
99291Critical care, first 30-74 minutes5554$0
View full utilization report →

Insurance plans in this area (ZIP 46616)

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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: 8022087642View full group profile
NameSpecialtyState
Nurse PractitionerIN
Emergency MedicineLA
-IN
Emergency MedicineIN
Emergency MedicineTN
-IN
Emergency MedicineIN
Emergency MedicineIN
Nurse PractitionerIN
Emergency MedicineMI

Reviews

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Frequently asked questions

What is DR. PETER RAY MARTIN (MD)'s NPI number?
DR. PETER RAY MARTIN (MD)'s NPI is 1104357490 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to DR. PETER RAY MARTIN (MD)?
You should see DR. PETER RAY MARTIN (MD) as active in CMS-hosted NPPES data.
What area of care is associated with DR. PETER RAY MARTIN (MD)?
DR. PETER RAY MARTIN (MD)'s record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. PETER RAY MARTIN (MD) located near South Bend?
DR. PETER RAY MARTIN (MD) currently maps to South Bend, Indiana in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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