DR. MARTIN RYAN FETZER D.O. NPI 1649499476

NPI Information

  • NPI: 1649499476
  • Provider Name: DR. MARTIN RYAN FETZER, D.O.
  • Classification: Physical Medicine & Rehabilitation - 2081P2900X
  • Specialization: Pain Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1801 S HIGHLAND AVE STE 220
    LOMBARD, IL
    ZIP 60148
  • Phone: (630) 967-2225

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NPI Details

DR. Martin Ryan Fetzer, D.O. is a pain medicine physical medicine rehabilitation in Lombard, IL with 20 years of experience. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. DR. Martin Ryan Fetzer, D.O. NPI is 1649499476. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1801 S HIGHLAND AVE STE 220
LOMBARD, IL
ZIP 60148-932
Phone: (630) 967-2225
Fax: (630) 241-6906

The NPI 1649499476 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r (HCPCS:U0003)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within (HCPCS:U0005)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level (HCPCS:64484)
  • Aspiration and/or injection of fluid large joint using ultrasound guidance (HCPCS:20611)
  • Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Injection of lower or sacral spine facet joint using imaging guidance, second level (HCPCS:64494)
  • X-ray of lower and sacral spine, minimum of 4 views (HCPCS:72110)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64636)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)

The enumeration date for this NPI number is 4/24/2007 and was last updated on 8/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & RehabilitationOS014454PENNSYLVANIANo
2208100000XPhysical Medicine & Rehabilitation5101017042MICHIGANNo
3208100000XPhysical Medicine & Rehabilitation036129085ILLINOISNo
42081P2900XPhysical Medicine & RehabilitationPain Medicine036129085ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036129085MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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