Active NPI
Mark T Donvito, M.D.
- Emergency Medicine Physician
- Murphysboro, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036-077356
- Practice address
- 2 S Hospital Dr
Murphysboro, IL 62966-3333 - Phone
- (618) 684-3156
- Fax
- (618) 529-0524
- NPI assigned
- May 13, 2006
- Last updated
- Sep 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036-077356 | IL | Primary |
Addresses
Primary practice location
2 S Hospital Dr
Murphysboro, IL 62966-3333
Mailing address
405 W Jackson St
Carbondale, IL 62901-1462
Phone (800) 701-3381
Other practice location 1
201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171
Other practice location 2
405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036077356-4 | Medicaid | IL | |
| 1073564175 | Medicaid | KY |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdonvito13953@sih.direct-ci.com | ||
| Direct Messaging Address | mdonvito13953@sih.direct-ci.com | ||
| Direct Messaging Address | mdonvito13953@sih.direct-ci.com |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-077356 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinckneyville Community Hospital | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients |
Locations
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
405 W Jackson St
Carbondale, IL 62901
100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156
5383 State Route 154
Pinckneyville, IL 62274
Phone (618) 357-2131
Interoperability endpoints
- mdonvito13953@sih.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Pinckneyville, IL
- NPI 1689646523
-
dba SIH Medical Group
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1073564175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 W JACKSON ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629011462",
"telephone_number": "800-701-3381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 S HOSPITAL DR",
"city": "MURPHYSBORO",
"state": "IL",
"postal_code": "629663333",
"telephone_number": "618-684-3156",
"fax_number": "618-529-0524"
}
],
"practiceLocations": [
{
"address_1": "201 S 14th St",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629483631",
"country_code": "US",
"telephone_number": "618-942-2171",
"fax_number": "618-351-4917",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "405 W Jackson St",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011462",
"country_code": "US",
"telephone_number": "618-549-0721",
"fax_number": "618-457-0469",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONVITO",
"first_name": "MARK",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-13",
"last_updated": "2026-09-29",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-077356",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036077356-4",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073564175",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdonvito13953@sih.direct-ci.com",
"affiliation": "N",
"address_1": "201 S 14th St",
"city": "Herrin",
"state": "IL",
"country_code": "US",
"postal_code": "629483631",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdonvito13953@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2 S Hospital Dr",
"city": "Murphysboro",
"state": "IL",
"country_code": "US",
"postal_code": "629663333",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdonvito13953@sih.direct-ci.com",
"affiliation": "N",
"address_1": "405 W Jackson St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011462",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Murphysboro, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.