Active NPI
Mary Ann Emanuele, MD
- Endocrinology, Diabetes & Metabolism Physician
- Maywood, IL
National Provider Identifier
1902885080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 36054550
- Practice address
- 2160 S First Ave
Fahey Center Room 137
Maywood, IL 60153 - Phone
- (708) 216-8367
- Fax
- (708) 216-5936
- NPI assigned
- Jan 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 36054550 | IL | Primary |
Addresses
Primary practice location
2160 S First Ave
Fahey Center Room 137
Maywood, IL 60153
Mailing address
2160 S First Ave
Fahey Center Room 137
Maywood, IL 60153
Phone (708) 216-8367
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36054550 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | memanuele13302@direct.luhs.org | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 84.58 of 100
- Quality
- 68.78
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.32
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36054550 | IL | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients |
Locations
2160 S 1st Ave
Rm 137
Maywood, IL 60153
Phone (708) 216-8367
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1902885080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S FIRST AVE",
"address_2": "FAHEY CENTER ROOM 137",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "60153",
"telephone_number": "708-216-8367",
"fax_number": "708-216-5936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S FIRST AVE",
"address_2": "FAHEY CENTER ROOM 137",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "60153",
"telephone_number": "708-216-8367",
"fax_number": "708-216-5936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMANUELE",
"first_name": "MARY ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-17",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "IL",
"license": "36054550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36054550",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "memanuele13302@direct.luhs.org",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "2160 S First Ave",
"address_2": "Fahey Center Room 137",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "60153",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.