Lisa Marie Mascioli, APRN, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

277002175 Issued in IL

Practice address

385 Wirtz Dr
Dekalb, IL 60115-3067

Phone

(815) 306-2777

Fax

(815) 306-2778

NPI assigned

Sep 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  IL

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IL

  Medicare reassignment NPD
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Alpha Medical Services, LLC

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1194785857
  NPD

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1639627375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 WIRTZ DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601153067",
            "telephone_number": "815-306-2777",
            "fax_number": "815-306-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 WIRTZ DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601153067",
            "telephone_number": "815-306-2777",
            "fax_number": "815-306-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N East St",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "IL",
            "postal_code": "624502432",
            "country_code": "US",
            "telephone_number": "618-395-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASCIOLI",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.019809",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277002175",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277002175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa.mascioli.2@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccd",
            "address_1": "1200 N East St",
            "city": "Olney",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624502432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ramon Marquez, M.D.
• Dawn Marshall
• Herman E Martinez, PHARM.D.
• Rebecca Mascal
• Claire Maschinski
• Courtney Lea Mason, M.A.
• Faysal Massarweh
• Stephanie Maszczyk, LSW, CADC
• Joanne M Mata, P.T.A.
• Jazmn Samantha Matal

• All providers in Dekalb, IL
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.