Marion Diagnostic Center, Llc is a medicare enrolled "Clinic/center - Multi-specialty" provider in Marion, Illinois. Their current practice location is
3003 Civic Circle Blvd Suite 200, Marion, Illinois. You can reach out to their office (for appointments etc.) via phone at
(618) 993-1400.
Marion Diagnostic Center, Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Marion Diagnostic Center, Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1366543084.
Healthcare Provider's Profile
| Full Name | Marion Diagnostic Center, Llc |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 3003 Civic Circle Blvd Suite 200, Marion, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1366543084
- Provider Enumeration Date: 09/26/2006
- Last Update Date: 09/08/2022
Medicare PECOS Information:
- PECOS PAC ID: 0749289833
- Enrollment ID: O20061219000431
Medical Identifiers
Medical identifiers for Marion Diagnostic Center, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1366543084 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 207RH0003X | Internal Medicine - Hematology & Oncology | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 207Y00000X | Otolaryngology | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Secondary |
| 208800000X | Urology | (* (Not Available)) | Secondary |
| 261QR0200X | Clinic/center - Radiology | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Marion Diagnostic Center, Llc acts as a billing entity for following providers:
| Provider Name | Robert Lawrence Hatchett |
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| Provider Type | Practitioner - Urology |
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| Provider Identifiers | NPI Number: 1336210624
PECOS PAC ID: 3678479508
Enrollment ID: I20051227000080 |
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| Provider Name | Sean E Mccain |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1629050307
PECOS PAC ID: 3577553130
Enrollment ID: I20060208000415 |
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| Provider Name | Thomas J Pliura |
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| Provider Type | Practitioner - Emergency Medicine |
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| Provider Identifiers | NPI Number: 1124054010
PECOS PAC ID: 0648241208
Enrollment ID: I20060227000622 |
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| Provider Name | Clay O Demattei |
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| Provider Type | Practitioner - General Surgery |
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| Provider Identifiers | NPI Number: 1881621910
PECOS PAC ID: 2365413929
Enrollment ID: I20060823000454 |
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| Provider Name | Khalid Javed |
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| Provider Type | Practitioner - Internal Medicine |
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| Provider Identifiers | NPI Number: 1174529663
PECOS PAC ID: 5092708255
Enrollment ID: I20061219000473 |
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| Provider Name | Kathy L Schierbaum |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1700906021
PECOS PAC ID: 8022201516
Enrollment ID: I20101015000966 |
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| Provider Name | Amy Blandford |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1598240145
PECOS PAC ID: 3476899337
Enrollment ID: I20190114001949 |
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| Provider Name | Milton A Roldan |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1790191385
PECOS PAC ID: 0749401206
Enrollment ID: I20190502000103 |
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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. Marion Diagnostic Center, Llc 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 |
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Marion Diagnostic Center, Llc
3003 Civic Circle Blvd Suite 200,
Marion, IL 62959-5259
Ph: (618) 993-1400 | Marion Diagnostic Center, Llc
3003 Civic Circle Blvd Suite 200,
Marion, IL 62959-5259
Ph: (618) 993-1400 |
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