Mario Gerard Massullo, DO - Medicare Cardiac Surgery in Kankakee, IL

Mario Gerard Massullo, DO is a medicare enrolled "Internal Medicine - Cardiovascular Disease" physician in Kankakee, Illinois. He went to Ohio University, College Of Osteopathic Medicine and graduated in 1988 and has 36 years of diverse experience with area of expertise as Cardiac Surgery. He is a member of the group practice Presence Healthcare Services and 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 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 1043228158.

Contact Information

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



Physician's Profile

Full NameMario Gerard Massullo
GenderMale
SpecialityCardiac Surgery
Experience36 Years
Location1710 W. Court St., Kankakee, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mario Gerard Massullo attended and graduated from Ohio University, College Of Osteopathic Medicine in 1988
  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.
IdentifierTypeStateIssuer
1043228158NPI-NPPES
036082059MedicaidIL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 036082059 (Illinois)Secondary
207RI0011XInternal Medicine - Interventional Cardiology 036082059 (Illinois)Secondary
207RC0000XInternal Medicine - Cardiovascular Disease 036082059 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Presence St Marys HospitalKankakee, ILHospital
Riverside Medical CenterKankakee, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Presence Healthcare Services2860396769401

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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 NameSpecialty Physicians Of Illinois Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124075676
PECOS PAC ID: 4183529456
Enrollment ID: O20031201000602

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Entity NamePresence Healthcare Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932216819
PECOS PAC ID: 2860396769
Enrollment ID: O20050215000965

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Entity NamePresence Healthcare Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356727127
PECOS PAC ID: 2860396769
Enrollment ID: O20150810001673

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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. 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 AddressPractice 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

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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: Accepting Medicare Assignments
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: Accepting Medicare Assignments
Practice Location: 555 W Court St, Suite 400, Kankakee, IL 60901
Phone: 815-932-4614    Fax: 815-932-4615

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