Joanne Marie Ilustre, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS015002 Issued in PA

Practice address

1 Bartol Ave Ste 10
Ridley Park, PA 19078-2214

Phone

(610) 521-0150

Fax

(610) 521-6493

NPI assigned

Jul 10, 2008

Last updated

Jan 6, 2021By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, DE, MD3 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 3

Specialty

Cardiovascular Disease (Cardiology)

Education

New York College of Osteo Medicine of New York Institute of Technology, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001
• Union Hospital of Cecil County Hospital, Elkton, MD, CCN 210032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

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.

• Christiana Care Health Services, Inc

  dba CCHS Pmri

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment Care Compare group NPD
• Union Hospital of Cecil County

  • Internal Medicine Physician
  • Elkton, MD
  • NPI 1124067848

  Interventional Cardiology

  Medicare reassignment Care Compare group NPD
• Christiana Care Pennsylvania Inc

  dba CCHS Imaging PA

  • Diagnostic Radiology Physician
  • West Grove, PA
  • NPI 1467298299
  Medicare reassignment
• Christiana Care Health Services Inc

  dba CCHS Concord - Neurology

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Christiana Care Health Services, Inc

  dba CCHS Cardiac Services

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1003850504
  NPD
• Union Hospital of Cecil County, Inc.

  dba Union Palliative Care

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Elkton, MD
  • NPI 1497506968
  NPD

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

• Christiana Care Health Services, Inc.

  dba Christiana Care

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation
• Union Hospital of Cecil County

  • General Acute Care Hospital
  • Elkton, MD
  • NPI 1376523357
  Care Compare affiliation

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1750545661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 SILVERSIDE RD",
            "address_2": "STE 1C",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104900",
            "telephone_number": "267-479-4142",
            "fax_number": "215-463-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARTOL AVE STE 10",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782214",
            "telephone_number": "610-521-0150",
            "fax_number": "610-521-6493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 MEDICAL CENTR BLVD",
            "address_2": "P O Bldg 1 - Suite 400",
            "address_purpose": "LOCATION",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "country_code": "US",
            "telephone_number": "610-876-2400",
            "fax_number": "610-876-4308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1088 W. Baltimore Pike",
            "address_2": "4th Floor Suite 2400",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190631906",
            "country_code": "US",
            "telephone_number": "610-565-2100",
            "fax_number": "610-892-0626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILUSTRE",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "DE",
            "license": "C20011444",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS015002",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "OS015002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035757110003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hematology-Oncology Associates
• Patricia Barr Hickey
• Holcomb Behavioral Health Systems
• Barry Craig Holms, D.O.
• Suzanna Isabelle Hutchinson, MD
• Internists Associates
• John R Callahan DDS Assoc
• John Wade Seedor MD PC
• Lawrence Jones, MS, ATC
• David Raymond Kalodner, D.O.

• Cardiovascular Disease Physician in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.