Active NPI
Mark James Pisaneschi, MD
- Diagnostic Radiology Physician
- Chicago, IL
National Provider Identifier
1932144185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036-084676
- Practice address
- 1901 W Harrison St
Dept of Radiology
Chicago, IL 60612-3714 - Phone
- (312) 864-6000
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036-084676 | IL | Primary |
Addresses
Primary practice location
1901 W Harrison St
Dept of Radiology
Chicago, IL 60612-3714
Mailing address
0N 771 Woodlawn St.
Wheaton, IL 60187
Phone (630) 690-9299
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mpisanesch@direct.ccprovider.org | Direct | Cook County |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250605003028 | IL | Order and Referring Only - Diagnostic Radiology | 2264435015 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- mpisanesch@direct.ccprovider.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619568000000",
"number": "1932144185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "0N 771 WOODLAWN ST.",
"city": "WHEATON",
"state": "IL",
"postal_code": "60187",
"telephone_number": "630-690-9299",
"fax_number": "630-690-3149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 W HARRISON ST",
"address_2": "DEPT OF RADIOLOGY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123714",
"telephone_number": "312-864-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PISANESCHI",
"first_name": "MARK",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036-084676",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpisanesch@direct.ccprovider.org",
"affiliation": "Y",
"affiliationName": "Cook County",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1969 W. Ogden Ave.",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606123723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.