James Massimilian, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036079253 Issued in IL

Practice address

12251 S 80TH Ave
Palos Heights, IL 60463-1256

Phone

(708) 923-5800

Fax

(708) 923-8324

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Palos Emergency Medical Services, LTD

  • Emergency Medicine Physician
  • Palos Heights, IL
  • NPI 1811997885
  NPD (past)
• Suburban Emergency Physicians Group, SC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1245210038
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1598766966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9944 S ROBERTS RD",
            "address_2": "SUITE 204",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651555",
            "telephone_number": "708-233-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5800",
            "fax_number": "708-923-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIMILIAN",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036079253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily A Marszalek, MS, OTR/L
• Leynard M Martinez, MD
• Maryann L Maher Otrl LTD
• Haley Ann Mascitti, O.D.
• Cora Mason
• Cynthia H. Mastbrook, D.O.
• Frank Matheu, D.O.
• Mekha Mathew, DO
• Judith Mattox, NP
• Julie Maty, MS,PT

• Emergency Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.