Individual provider Active NPI

Maria L Fassari, MD

  • Internal Medicine Physician
  • Janesville, WI
National Provider Identifier
1295860500
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
67628-20 Issued in WI
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, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1295860500MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
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, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070601000495 IL Practitioner - HospitalistPractitioner - Internal Medicine 3779681515 Reassigns benefits to 2 organizations
I20180110002844 WI Practitioner - Internal MedicinePractitioner - Hospitalist 3779681515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2015
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)

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

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 20, 2023 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Dec 26, 2021 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Jan 30, 2023 Accepting new patients
Elmhurst Memorial Healthcare Internal Medicine CurrentSince Jan 30, 2023 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Nov 20, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 13, 2017 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 13, 2017 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Dec 26, 2021 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.