Denise Pine-Mattas, MD
Individual provider Active NPI Family Medicine Physician · Marshall, IL
NPI 1659313989 · NPPES record last updated Oct 18, 2010
Key facts
- NPI
- 1659313989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036114511 (IL)
- Practice address
- 410 N 2ND St
Marshall, IL 62441-1010 - Phone
- (217) 826-2361
- Fax
- (217) 826-2366
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Union Hospital Inc
Union Associated Physicians Clinic, LLC
Practice addresses (Care Compare)
1606 N 7TH St
Union Hospital Inc Medical Group
Terre Haute, IN 47804-2706
Phone (812) 238-7000
221 S 6 TH St
Apands Clinic Downtown
Terre Haute, IN 47807-4214
Phone (812) 232-0564
410 N 2ND St
Marshall, IL 62441-1010
Phone (217) 826-2361
Hospital & facility affiliations
- Union Hospital Inc
- Paris Community Hospital
- Union Hospital Clinton
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070625000742 | IN | Practitioner - Family Practice | 2264531698 | Reassigns benefits to 2 organizations |
| I20070730000841 | IL | Practitioner - Family Practice | 2264531698 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036114511 | IL | MD | Family Medicine Physician |
| 01060692A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Medical Management, P.C. | Current | Accepting new patients | |
| Union Hospital, Inc. | Current |
Accepting new patients | |
| Union Hospital, Inc. | Family Medicine | Current |
Accepting new patients |
| Union Associated Physicians Clinic, LLC | Family Medicine | Current |
Accepting new patients |
| Union Hospital Inc. | Current | Accepting new patients | |
| Union Associated Physicians Clinic LLC | Family Medicine | Current |
Accepting new patients |
| Union Hospital Inc | Family Medicine | Current |
Accepting new patients |
| Union Hospital Inc. | Family Medicine | Past | Accepting new patients |
Locations
408 N 2nd St
Marshall, IL 62441
Phone (217) 826-2361
410 N 2nd St
Marshall, IL 62441
Phone (217) 826-2358
315 Lankford St
Clay City, IN 47841
Phone (812) 939-2126
2133 S State Road 46
Terre Haute, IN 47803
Phone (812) 242-3737
1513 N 6th St
Terre Haute, IN 47807
Phone (812) 238-7631
221 S 6th St
Terre Haute, IN 47807
Phone (812) 242-3157
1801 N 6th St
Ste 200
Terre Haute, IN 47804
Phone (812) 238-7301
1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036114511 | IL | Yes |
| Family Medicine Physician | 207Q00000X | 01060692A | IN |
Addresses
Primary practice location
410 N 2ND St
Marshall, IL 62441-1010
Mailing address
PO Box 2505
Indianapolis, IN 46206-2505
Phone (812) 238-7783
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00459732 | Other | IL | RR MEDICARE |
| 200876850 | Medicaid | IN | |
| P00459735 | Other | IN | RR MEDICARE |
| 036114511 | Medicaid | IL |
Other providers in Marshall, IL
- Marlene McDonald-Smithson
- Michaela Marie Miller
- Holly Newkirk
- Marilyn Sue Patton
- Bret Tibay Pelesco
- Gayle Rayhel
- Restoration Dental LLC- Marshall Dental Professionals
- Rhoads to Healthy LLC
- Selah Partners, LLC
- SGM Physical Therapy
All providers in Marshall, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.