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Deactivated NPI 1801888276 Deactivated / Inactive NPI Male Practitioner

Dr. Tom D Martin , MD

Internal Medicine • Centralia, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Tom Martin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 22, 2005
NPI Deactivation Date March 25, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Tom Martin, MD was a registered Internal Medicine practicing in Centralia, IL. Throughout an active medical career spanning 1 years, Dr. Martin provided care at the practice location at 1050 M L KING DR until profile deactivation on 2006-03-25.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, insertion of needle into vein for collection of blood sample. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1050 M L King Dr
Suite 104

Centralia, IL 628013060

Telephone 6185326330
Fax 6185327227
Associated Practice Facility / Clinic
🏢 Naeem A Khan Md Sc Facility NPI 1790810216

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Centralia, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 33.7 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
5 Specialists

Practicing in Centralia, IL (7544 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
59.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
134 48 $139.00 $71.90
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
19 19 $273.00 $105.33
36415 Insertion of needle into vein for collection of blood sample
15 12 $27.00 $2.94

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IL 3640120

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1114120177

Doctor of Medicine (M.D.)

Dr. Rajendra Shroff , MD

Internal Medicine

NPI 1245259274

Doctor of Medicine (M.D.)

Dr. Aziz Rahman , MD

Internal Medicine - Pulmonary Disease

NPI 1275540015

Doctor of Medicine (M.D.)

NPI 1780681700

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated April 17, 2024

Record deactivated on April 17, 2024

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Updated Practice Location July 23, 2009

Registered at 1050 M L KING DR, SUITE 104, CENTRALIA, IL 628013060 (Tel: 6185326330)

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Updated Business Mailing Address July 23, 2009

Registered at 1050 M L KING DR, SUITE 104, CENTRALIA, IL 628013060 (Tel: 6185326330)

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Provider Name / Credentials Updated July 23, 2009

Recorded as TOM MARTIN, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2009

Internal Medicine (License #3640120 in IL)

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NPI Profile Reactivated April 04, 2006

Record officially reactivated for active practice on April 04, 2006

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NPI Profile Deactivated March 25, 2006

Record deactivated on March 25, 2006

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Initial NPI Registration & Enumeration August 22, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801888276
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2005
Last Update: July 23, 2009
Deactivation Date: March 25, 2006

Mailing Address

1050 M L King Dr, Suite 104

Centralia, IL 628013060

Phone: 6185326330

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.