Loris A Tisocco, MD is a medicare enrolled "Dermatology" physician in Calumet City, Illinois. His current practice location is
19 River Oaks Dr, Calumet City, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 862-1290.
Loris A Tisocco is licensed to practice in Illinois (license number 036054667) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205896008.
Physician's Profile
Full Name | Loris A Tisocco |
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Gender | Male |
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Speciality | Dermatology |
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Location | 19 River Oaks Dr, Calumet City, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205896008
- Provider Enumeration Date: 03/24/2006
- Last Update Date: 01/28/2020
Medicare PECOS Information:
- PECOS PAC ID: 5496647042
- Enrollment ID: I20040329000399
Medical Identifiers
Medical identifiers for Loris A Tisocco such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205896008 | NPI | - | NPPES |
200015120A | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | 036054667 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Loris A Tisocco allows following entities to bill medicare on his behalf.
Entity Name | Pinnacle Dermatology Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1861930984 PECOS PAC ID: 8628353380 Enrollment ID: O20170320000738 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Loris A Tisocco is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Loris A Tisocco, MD 580 E Boughton Rd, Ste A, Bolingbrook, IL 60440-2565 Ph: (815) 744-8554 | Loris A Tisocco, MD 19 River Oaks Dr, Calumet City, IL 60409 Ph: (708) 862-1290 |
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