Mary Anne Depaz, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

036-101577 Issued in IL

Practice address

210 W. McKinley Ave
Ste 2
Decatur, IL 62526

Phone

(217) 876-6600

Fax

(217) 876-6606

NPI assigned

Mar 24, 2006

Last updated

Feb 26, 2019By the provider in NPPES

Sex

Female

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 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Radiation OncologyAlso: Internal Medicine

Education

Rush Medical College of Rush University, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer Care Specialists of Central Illinois SCGroup PAC ID 5991619116, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
• Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973

  Corporate Director

  CMS ownership

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.

• Cancer Care Specialists of Central Illinois, S.C.

  • Medical Oncology Physician
  • Decatur, IL
  • NPI 1871580142

  Radiation Oncology

  Medicare reassignment Care Compare group NPD
• Cancer Care Specialists of Central Illinois, S.C

  dba Cancer Care Specialists of Illinois

  • Community/Retail Pharmacy
  • Decatur, IL
  • NPI 1356874093
  NPD
• Decatur Memorial Hospital

  dba Professional Fees

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD (past)

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

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973
  Care Compare affiliation
• Taylorville Memorial Hospital

  • Critical Access Hospital
  • Taylorville, IL
  • NPI 1144292020
  Care Compare affiliation

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1700846664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W. MCKINLEY AVE",
            "address_2": "STE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-876-6600",
            "fax_number": "217-876-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W. MCKINLEY AVE",
            "address_2": "STE 2",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-876-6600",
            "fax_number": "217-876-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAZ",
        "first_name": "MARY ANNE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036-101577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101577",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-101577",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline R Dennis, LPN
• Hillary Denny, D.P.T
• Jeffrey Luke Denny, PA
• Dental Professionals of Illinois, P.C. (Long Creek Dental)
• Department of Veterans Affairs
• Marcus S Deranian, M.D.
• Yashvi Falguni Desai
• Allen Bernard Devleschoward Jr., M.D.
• Devoted Caregivers
• Nakeya Khozema Dewaswala, MD

• Radiation Oncology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Radiation Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.