Mary C Massa, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Practice address

6319 Fairview Ave
Suite 102
Westmont, IL 60559-2888

Phone

(630) 968-4500

Fax

(630) 968-4420

NPI assigned

Aug 8, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Rockford Psychiatric Medical Services, S.C.

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  • NPI 1821391442
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336159839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 264",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-2195",
            "fax_number": "312-563-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6319 FAIRVIEW AVE",
            "address_2": "SUITE 102",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592888",
            "telephone_number": "630-968-4500",
            "fax_number": "630-968-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSA",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Korrie Martz-Stapel, LPC - INTERN
• Bana Ahdab Mashnouk, DDS
• Emilia Maslany
• Katherine Balos Maslar
• Carla Mason, BA
• Megan Ryan Mateja
• Melvin Mathew
• Katherine Orallo Matias-Riggs, PT
• Andrew Ryan Matthews
• Mark May, D.C.

• Dermatology Physician in Westmont, IL
• Providers in Westmont, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.