NPIMap

Individual provider Active NPI

Melissa Ann Dianovsky, MD

  • Pediatrics Physician
  • Arlington Heights, IL
National Provider Identifier
1306848858
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036090172 Issued in IL
Practice address
1614 W. Central Road
Suite 209
Arlington Heights, IL 60005
Phone
(847) 259-5070
Fax
(847) 259-5322
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036090172 IL Primary

Addresses

Primary practice location

1614 W. Central Road
Suite 209
Arlington Heights, IL 60005

Mailing address

1614 W. Central Road
Suite 209
Arlington Heights, IL 60005
Phone (847) 259-5070

Other identifiers 1

IdentifierTypeStateIssuer
036090172MedicaidIL

Other names 1

  • Melissa Ann Hoeppner Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036090172ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients
Pediatric Associates of Arlington Heights, PLLC Pediatrics Past Accepting new patients
Pediatrust, L.L.C. Pediatrics Past Accepting new patients
Pediatric Associates of Arlington HTS SC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mdianovsky134934@direct.luriechildrens.org
  • Direct secure messaging: mdianovshyhoeppner421366@direct.myadvocateaurora.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1306848858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 W. CENTRAL ROAD",
            "address_2": "SUITE 209",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60005",
            "telephone_number": "847-259-5070",
            "fax_number": "847-259-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 W. CENTRAL ROAD",
            "address_2": "SUITE 209",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60005",
            "telephone_number": "847-259-5070",
            "fax_number": "847-259-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIANOVSKY",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036090172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090172",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HOEPPNER",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.