Dr Martin Ryan Fetzer, DO is a medicare enrolled "Physical Medicine & Rehabilitation - Pain Medicine" physician in Lombard, Illinois. He graduated from medical school in 2006 and has 18 years of diverse experience with area of expertise as Physical Medicine And Rehabilitation. He is a member of the group practice Dupage Medical Group Ltd and his current practice location is
1801 S Highland Ave Ste 220, Lombard, Illinois. You can reach out to his office (for appointments etc.) via phone at
(630) 967-2225.
Dr Martin Ryan Fetzer is licensed to practice in Illinois (license number 036129085) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1649499476.
Physician's Profile
| Full Name | Dr Martin Ryan Fetzer |
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| Gender | Male |
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| Speciality | Physical Medicine And Rehabilitation |
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| Experience | 18 Years |
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| Location | 1801 S Highland Ave Ste 220, Lombard, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Martin Ryan Fetzer graduated from medical school in 2006
NPI Data:
- NPI Number: 1649499476
- Provider Enumeration Date: 04/24/2007
- Last Update Date: 08/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 4981884780
- Enrollment ID: I20111230000609
Medical Identifiers
Medical identifiers for Dr Martin Ryan Fetzer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649499476 | NPI | - | NPPES |
| 036129085 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | OS014454 (Pennsylvania) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 5101017042 (Michigan) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 036129085 (Illinois) | Secondary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | 036129085 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Dupage Medical Group Ltd | 5496667941 | 1186 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Martin Ryan Fetzer allows following entities to bill medicare on his behalf.
| Entity Name | Dupage Medical Group Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801833983
PECOS PAC ID: 5496667941
Enrollment ID: O20031110000535 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Martin Ryan Fetzer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Martin Ryan Fetzer, DO
Po Box 713260,
Chicago, IL 60677-1260
Ph: (630) 469-9200 | Dr Martin Ryan Fetzer, DO
1801 S Highland Ave Ste 220,
Lombard, IL 60148-4932
Ph: (630) 967-2225 |
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