Mario Christianto, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

25MA10196500 Issued in NJ

Practice address

3000 New Bern Ave
Raleigh, NC 27610-1231

Phone

(919) 350-8000

NPI assigned

May 24, 2012

Last updated

Feb 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, OH, OR, IA4 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 4

Specialty

Critical Care (Intensivists)Also: Pulmonary Disease

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Iowa Hospital CorporationGroup PAC ID 0749198026, 139 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146
• Buena Vista Regional Medical Center Hospital, Storm Lake, IA, CCN 161375
• Cherokee Regional Medical Center Hospital, Cherokee, IA, CCN 161362

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mchristianto740882@oc.providencedirect.org
• Direct secure messaging: mchristianto901211@direct.unitypoint.org

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.

• Northwest Iowa Hospital Corporation

  dba St. Luke's Regional Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550
  Medicare reassignment Care Compare group NPD
• Moses Cone Medical Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1427095249
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Ohio, Professional Corporation

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1043572290
  Medicare reassignment NPD
• Iowa Physicians Clinic Medical Foundation

  dba UnityPoint Clinic

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Internal Medicine

  Medicare reassignment NPD
• Somc Medical Care Foundation, Inc.

  • Family Medicine Physician
  • Portsmouth, OH
  • NPI 1457467227

  Pulmonary Disease

  Medicare reassignment NPD
• Sound Physicians Intensivists of Washington PLLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Spokane, WA
  • NPI 1528582699

  OR

  Medicare reassignment NPD
• Moses Cone Medical Services, Inc.

  dba Western Rockingham Family Medicine

  • Family Medicine Physician
  • Madison, NC
  • NPI 1629376363
  NPD
• Wakemed Specialists Group LLC

  dba WakeMed - Virtual Cardiac Rehab

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group LLC

  • Orthopaedic Surgery Physician
  • Raleigh, NC
  • NPI 1417512690
  NPD
• Somc Medical Care Foundation, Inc.

  dba Somc Radiology Associates

  • Diagnostic Radiology Physician
  • Portsmouth, OH
  • NPI 1366686230
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Buena Vista Regional Medical Center

  • Critical Access Hospital
  • Storm Lake, IA
  • NPI 1134191653
  Care Compare affiliation
• Northwest Iowa Hospital Corporation

  dba St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Sioux City, IA
  • NPI 1962594622
  Care Compare affiliation
• Sioux Valley Memorial Hospital Association

  dba Cherokee Regional Medical Center

  • Critical Access Hospital
  • Primghar, IA
  • NPI 1689640500
  Care Compare affiliation

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1457611337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANTO",
        "first_name": "MARIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA10196500",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-02334",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA10196500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchristianto740882@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1698 E McAndrews Rd Ste 400",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975045590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frank Howard Christensen, MD
• Hali Renee Christensen, ATS
• Christi M. Davis, DDS, PA III
• Christi M. Davis, DDS, PA, II
• Christian Counseling Associates of Raleigh, PLLC
• Christine Byrne Nutrition LLC (Ruby Oak Nutrition)
• Christine Byrne Nutrition LLC, Dba Ruby Oak Nutrition
• Christine D. Laster, DDS, PA
• Giles Christman, LMFTA
• Lisa Abernethy Christman, M.D.

• Critical Care Medicine (Internal Medicine) Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Critical Care Medicine (Internal Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.

Verify at the official NPI Registry.