Individual provider Active NPI

Maelen M Pantano, MD

  • Internal Medicine Physician
  • Elmhurst, IL
National Provider Identifier
1023068152
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086219 Issued in IL
Practice address
172 Schiller St
Elmhurst, IL 60126-2885
Phone
(331) 221-9001
Fax
(331) 221-2315
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036086219 IL Primary

Addresses

Primary practice location

172 Schiller St
Elmhurst, IL 60126-2885

Mailing address

4201 Winfield Rd FL 4
Warrenville, IL 60555-4025
Phone (331) 221-6377

Other practice location 1

303 W Lake St Ste 200
Addison, IL 60101-2500
Phone (331) 221-9001

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mpantano41822@direct.edward.org Direct
Direct Messaging Address mpantano41822@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100617000375 IL Practitioner - Internal Medicine 7012047046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

172 E Schiller St
Elmhurst, IL 60126-2816
Phone (331) 221-9001

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Residential Home Health Home health agency, Lisle, IL, CCN 147568
  • Safe Life Home Health Care, LLC Home health agency, Lombard, IL, CCN 148319
  • Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
  • Edward Hospital Hospital, Naperville, IL, CCN 140231

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036086219ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 20, 2023 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Dec 20, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Aug 1, 1994 Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

303 W Lake St
Ste 200
Addison, IL 60101

9532 Eagle Way
Chicago, IL 60678

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

4201 Winfield Rd
Fl 4
Warrenville, IL 60555

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1023068152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 4",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025",
            "telephone_number": "331-221-6377",
            "fax_number": "331-221-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 SCHILLER ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262885",
            "telephone_number": "331-221-9001",
            "fax_number": "331-221-2315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 W Lake St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "IL",
            "postal_code": "601012500",
            "country_code": "US",
            "telephone_number": "331-221-9001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTANO",
        "first_name": "MAELEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpantano41822@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "303 W Lake St Ste 200",
            "city": "Addison",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601012500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpantano41822@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "172 Schiller St",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601262885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.