Active NPI
Maria L Fassari, MD
- Internal Medicine Physician
- Janesville, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 67628-20
- Practice address
- 3400 E Racine St
Janesville, WI 53546-2344 - Phone
- (608) 373-8000
- Fax
- (608) 373-8514
- NPI assigned
- Feb 23, 2007
- Last updated
- Nov 12, 2020
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-116724 | IL | |
| Internal Medicine Physician | 207R00000X | 67628-20 | WI | Primary |
Addresses
Primary practice location
3400 E Racine St
Janesville, WI 53546-2344
Mailing address
1808 W Beltline Hwy
Madison, WI 53713-2334
Phone (608) 250-1497
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295860500 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | mfassari348360@direct-ehr-ssmhc.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096
177 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (630) 646-6020
2650 Ridge Ave
Evanston, IL 60201-1700
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Reedsburg Area Medical Center Inc | Current | Accepting new patients | |
| Elmhurst Memorial Healthcare | Current | Accepting new patients | |
| Elmhurst Memorial Healthcare | Internal Medicine | Current | Accepting new patients |
| Endeavor Health Medical Group | Internal Medicine | Current | Accepting new patients |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Reedsburg Area Medical Center, Inc. | Current | Accepting new patients | |
| Wyse Eyecare SC | Past | Accepting new patients | |
| Stoughton Hospital Association | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
9532 Eagle Way
Chicago, IL 60678
155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521
172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
3400 E Racine St
Janesville, WI 53546
Phone (608) 373-8000
2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487
900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410
Interoperability endpoints
- mfassari255098@direct.edward.org
Organizations & group practices 10
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.
-
dba NorthShore University HealthSystem Faculty Practice Associates
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
Internal Medicine
-
dba MHS Physician Services
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
- Critical Access Hospital
- Reedsburg, WI
- NPI 1891796710
-
dba Elmhurst Clinic
- Multi-Specialty Clinic/Center
- Elmhurst, IL
- NPI 1457493454
-
dba Mercy Walworth Hospital and Medical Center
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
dba RAMC La Valle Clinic
- Rural Health Clinic/Center
- La Valle, WI
- NPI 1437049566
-
- Internal Medicine Physician
- Elmhurst, IL
- NPI 1497076392
-
dba NorthShore Anesthesia Group
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
-
- Critical Access Hospital
- Stoughton, WI
- NPI 1679558647
-
- Ophthalmology Physician
- Northbrook, IL
- NPI 1316272289
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Endeavor Health Elmhurst Hospital
- General Acute Care Hospital
- Elmhurst, IL
- NPI 1548306343
-
dba Endeavor Health Swedish Hospital
- General Acute Care Hospital
- Chicago, IL
- NPI 1831151257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1295860500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 W BELTLINE HWY",
"city": "MADISON",
"state": "WI",
"postal_code": "537132334",
"telephone_number": "608-250-1497",
"fax_number": "608-250-1453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 E RACINE ST",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535462344",
"telephone_number": "608-373-8000",
"fax_number": "608-373-8514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASSARI",
"first_name": "MARIA",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-116724",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "67628-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1295860500",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "3400 E Racine St",
"city": "Janesville",
"state": "WI",
"country_code": "US",
"postal_code": "535462344",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mfassari348360@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "mfassari348360@direct-ehr-ssmhc.com",
"address_1": "3400 E Racine St",
"city": "Janesville",
"state": "WI",
"country_code": "US",
"postal_code": "535462344",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.