Active NPI
Mary Elizabeth Gorman, M.D.
- Otolaryngology Physician
- Mattoon, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036175158
- Practice address
- 1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653 - Phone
- (217) 258-2409
- Fax
- (217) 258-2323
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036175158 | IL | Primary |
| Otolaryngology Physician | 207Y00000X | D69143 | MD |
Addresses
Primary practice location
1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653
Mailing address
PO Box 372
Mattoon, IL 61938-0372
Other names 1
- Mary Elizabeth Pescitelli
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, MA, IL, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1005 Health Ctr Dr
Suite 201
Mattoon, IL 61938-4653
Phone (217) 258-2409
Hospital & facility affiliations
- Sarah Bush Lincoln Health Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036175158 | IL | MD | Otolaryngology Physician |
| D69143 | MD | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Lakeland Regional Health Systems, Inc. | Current | Accepting new patients | |
| Ear, Nose & Throat Consultants, Inc | Otolaryngology | Current | Accepting new patients |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients |
Locations
3030 Harden Blvd
Lakeland, FL 33803
Phone (863) 687-1222
1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132
3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565
1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055
101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730
1007 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-7400
1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389
1021 Main St
Ste 105
Winchester, MA 01890
Phone (781) 729-8845
100 Sylvan Rd
Ste 750
Woburn, MA 01801
Phone (781) 731-3001
1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000
2101 E Jefferson St
#4E
Rockville, MD 20852
2101 E Jefferson St
Ste 4EPEU
Rockville, MD 20852
2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
- Otolaryngology Physician
- Woburn, MA
- NPI 1942209655
-
- Ambulatory Surgical Clinic/Center
- Halethorpe, MD
- NPI 1942546486
-
- Multi-Specialty Clinic/Center
- Lakeland, FL
- NPI 1497748743
-
- Rural Health Clinic/Center
- Greenville, IL
- NPI 1811858970
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748476800000",
"number": "1063636041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 372",
"city": "MATTOON",
"state": "IL",
"postal_code": "619380372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 HEALTH CENTER DR STE 201",
"city": "MATTOON",
"state": "IL",
"postal_code": "619384653",
"telephone_number": "217-258-2409",
"fax_number": "217-258-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2025-05-29",
"certification_date": "2025-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036175158",
"primary": true
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MD",
"license": "D69143",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1221 Mercantile Ln",
"city": "Largo",
"state": "MD",
"country_code": "US",
"postal_code": "207745374",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARY",
"last_name": "PESCITELLI",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.