Mark P Iltis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27823 Issued in IA

Practice address

619 5TH Street
Durant, IA 52747

Phone

(563) 785-4487

Fax

(563) 785-6681

NPI assigned

Oct 7, 2005

Last updated

May 27, 2021By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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 1

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.iltis@direct.genesishealth.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.

• Genesis Health System

  dba Genesis Convenient Care Bettendorf

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008
  Medicare reassignment Care Compare group
• Genesis Health System

  dba Genesis Health Group

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945
  NPD
• Genesis Health System

  dba Genesis Medical Center Dewitt

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• Genesis Health System

  dba Genesis Health Group

  • Family Medicine Physician
  • Bettendorf, IA
  • NPI 1225018211
  NPD (past)
• Genesis Health System

  • Surgery Physician
  • Davenport, IA
  • NPI 1528616901

  Family Medicine

  NPD (past)
• Genesis Health System

  dba Genesis Health Group

  • Family Medicine Physician
  • Moline, IL
  • NPI 1164538435
  NPD (past)
• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  NPD (past)

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

• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1659369353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "STE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "telephone_number": "563-355-9191",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 5TH STREET",
            "city": "DURANT",
            "state": "IA",
            "postal_code": "52747",
            "telephone_number": "563-785-4487",
            "fax_number": "563-785-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILTIS",
        "first_name": "MARK",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "27823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.iltis@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "619 5th Street",
            "city": "Durant",
            "state": "IA",
            "country_code": "US",
            "postal_code": "52747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Wayne Grunder, D.D.S.
• Anna M Hansen, PA-C
• Christina Hebeler
• Melissa Ann Hoogerwerf, D.C.
• Hy-Vee Inc (Hy-Vee Pharmacy (3062))
• Emily Ann Johnson, DO
• Brooke Lauren Lerma, LMT
• Lobo Inc (Westfair Drug)
• Melissa Kelling PLLC (Durant Chiropractic Clinic)
• Ora Orthopedics, PC

• Family Medicine Physician in Durant, IA
• Providers in Durant, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.