Edgar J Massabni, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

51186 Issued in WI

Practice address

3100 Shore Dr
Marinette, WI 54143-4242

Phone

(715) 735-8067

Fax

(715) 732-8224

NPI assigned

Apr 25, 2006

Last updated

Mar 30, 2020By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in WI, MI2 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 2

Specialty

Interventional Cardiology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickinson County Healthcare SystemGroup PAC ID 6800784943, 103 clinicians

DLP Marquette Physician Practices IncGroup PAC ID 9931359601, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342
• Dickinson County Memorial Hospital Hospital, Iron Mountain, MI, CCN 230055
• Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054
• Aspirus Iron River Hospital & Clinics, Inc Hospital, Iron River, MI, CCN 231318

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edgar.massabni.1@22710.direct.athenahealth.com
• Direct secure messaging: edgar.massabni.1@8233.direct.athenahealth.com

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.

• Dickinson County Healthcare System

  dba Marshfield Medical Center - Dickinson Professional Services

  • Emergency Medical Services (Emergency Medicine) Physician
  • Iron Mountain, MI
  • NPI 1891751186
  Medicare reassignment Care Compare group NPD
• DLP Marquette Physician Practices Inc

  dba Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995
  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  dba MHS Physician Services

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Great Lakes Heart and Vascular, LLC

  • Cardiovascular Disease Physician
  • Marinette, WI
  • NPI 1487973269
  Authorized official Same address or phone
• Mercy Health System Corporation

  dba Mercy Hospital Janesville

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Health System Corporation

  dba Mercy Walworth Hospital and Medical Center

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• DLP Marquette Physician Practices Inc

  dba Marquette General Heart and Vascular Institute

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Marquette, MI
  • NPI 1073861431
  NPD
• DLP Marquette Physician Practices Inc

  dba UP Health System Pediatric Specialists

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD (past)
• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  NPD (past)

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

• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Clinic

  • Multi-Specialty Clinic/Center
  • Iron River, MI
  • NPI 1457865198

  Hospital

  Care Compare affiliation
• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Hospital

  • Critical Access Hospital
  • Iron River, MI
  • NPI 1497750830
  Care Compare affiliation
• Dickinson County Healthcare System

  dba Marshfield Medical Center - Dickinson

  • Critical Access Hospital
  • Iron Mountain, MI
  • NPI 1841188604
  Care Compare affiliation
• DLP Marquette General Hospital LLC

  dba UP Health System Marquette

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  Care Compare affiliation

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1649236829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434242",
            "telephone_number": "715-735-8067",
            "fax_number": "715-732-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSABNI",
        "first_name": "EDGAR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301093535",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "51186-20",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "51186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "007100492",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marinette Menominee Prescription Center LTD (Valucare Center Health Mart Pharmacy)
• Marinette School District
• Marinette-Menominee Prescription Center LTD (ValuCare Long Term Care)
• Lynette Mary Marklein, PT, DPT, ATC
• Anthony R Mars, MD
• Michael G Massee, MD
• Amandeep Matharu
• Heidi Jean Maye, LPC
• Stacie Mayland
• Susan McBride, MFT

• Interventional Cardiology Physician in Marinette, WI
• Providers in Marinette, WI by specialty
• Interventional Cardiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.