Mario Gerard Massullo, DO in Kankakee, IL - Medicare Internal Medicine

Mario Gerard Massullo, DO is a medicare enrolled "Internal Medicine - Cardiovascular Disease" physician in Kankakee, Illinois. His current practice location is 1710 W. Court St., Kankakee, Illinois. You can reach out to his office (for appointments etc.) via phone at (815) 936-3200.

Mario Gerard Massullo is licensed to practice in Illinois (license number 036082059) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043228158.

Contact Information

	Mario Gerard Massullo, DO
	1710 W. Court St., Kankakee, IL 60901
	(815) 936-3200
	(815) 936-3203

Map and Direction

Physician's Profile

Full Name	Mario Gerard Massullo
Gender	Male
Speciality	Internal Medicine - Cardiovascular Disease
Location	1710 W. Court St., Kankakee, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043228158
Provider Enumeration Date: 08/04/2006
Last Update Date: 10/27/2021

Medicare PECOS Information:

PECOS PAC ID: 3577554690
Enrollment ID: I20040519000182

Medical Identifiers

Medical identifiers for Mario Gerard Massullo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043228158	NPI	-	NPPES
036082059	Medicaid	IL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	036082059 (Illinois)	Secondary
207RI0011X	Internal Medicine - Interventional Cardiology	036082059 (Illinois)	Secondary
207RC0000X	Internal Medicine - Cardiovascular Disease	036082059 (Illinois)	Primary

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. Mario Gerard Massullo allows following entities to bill medicare on his behalf.

Entity Name	Specialty Physicians Of Illinois Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1124075676 PECOS PAC ID: 4183529456 Enrollment ID: O20031201000602

Entity Name	Presence Healthcare Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932216819 PECOS PAC ID: 2860396769 Enrollment ID: O20050215000965

Entity Name	Presence Healthcare Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356727127 PECOS PAC ID: 2860396769 Enrollment ID: O20150810001673

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. Mario Gerard Massullo 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
Mario Gerard Massullo, DO 1710 W Court St, Kankakee, IL 60901-3160 Ph: (815) 936-3200	Mario Gerard Massullo, DO 1710 W. Court St., Kankakee, IL 60901 Ph: (815) 936-3200

Reviews and Comments

Internal Medicine Doctors in Kankakee, IL

Dr. Martin T Phillips, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 555 W Court St, Suite 108, Kankakee, IL 60901 Phone: 888-220-6432 Fax: 630-654-4253
Dr. Raju Zachariah Abraham, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 500 N Wall St Ste C400, Kankakee, IL 60901 Phone: 815-933-3814 Fax: 815-933-3846
Dr. Lynn G Brown, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 500 N Wall St, Kankakee, IL 60901 Phone: 844-404-4787 Fax: 815-936-3243
Dr. Samrat Umesh Khanna, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 500 N Wall St Ste C400, Kankakee, IL 60901 Phone: 815-933-3814 Fax: 815-933-3846
Dr. Rahul Patel, Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 350 N Wall St, Kankakee, IL 60901 Phone: 815-933-1671
Dr. Suresh K Didwania, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 555 W Court St, Suite 400, Kankakee, IL 60901 Phone: 815-932-4614 Fax: 815-932-4615

Mario Gerard Massullo, DO - Medicare Internal Medicine in Kankakee, IL