Ms Jennifer Marsidi, DO is a medicare enrolled "Internal Medicine" in Chicago, Illinois. Her current practice location is
1645 W Jackson Blvd Ste 215, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at
(312) 942-3254.
Ms Jennifer Marsidi is licensed to practice in Illinois (license number 125.077691) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1275713588.
Provider's Profile
| Full Name | Ms Jennifer Marsidi |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Location | 1645 W Jackson Blvd Ste 215, Chicago, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1275713588
- Provider Enumeration Date: 11/05/2007
- Last Update Date: 05/24/2021
Medicare PECOS Information:
- PECOS PAC ID: 1759470123
- Enrollment ID: I20150708001948
Medical Identifiers
Medical identifiers for Ms Jennifer Marsidi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275713588 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | AP30007951 (Washington) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | 125.077691 (Illinois) | Primary |
| 208000000X | Pediatrics | 125.077691 (Illinois) | Secondary |
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. Ms Jennifer Marsidi allows following entities to bill medicare on her behalf.
| Entity Name | Mercy Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629078712
PECOS PAC ID: 6103737812
Enrollment ID: O20040217000943 |
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| Entity Name | Maine Medical Partners |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073527388
PECOS PAC ID: 9335043967
Enrollment ID: O20050401000844 |
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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. Ms Jennifer Marsidi 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 |
|---|
Ms Jennifer Marsidi, DO
1645 W Jackson Blvd Ste 215,
Chicago, IL 60612-3227
Ph: (312) 942-3254 | Ms Jennifer Marsidi, DO
1645 W Jackson Blvd Ste 215,
Chicago, IL 60612-3227
Ph: (312) 942-3254 |
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