Mark Idstrom, MD in Shawnee Mission, KS

Mark Idstrom, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Shawnee Mission, Kansas. His current practice location is 9100 W 74th St, Shawnee Mission, Kansas. You can reach out to his office (for appointments etc.) via phone at (913) 676-2310.

Mark Idstrom is licensed to practice in Missouri (license number R2J97) 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 1639264443.

Contact Information

	Mark Idstrom, MD
	9100 W 74th St, Shawnee Mission, KS 66204-4004
	(913) 676-2310
	Not Available

Map and Direction

Physician's Profile

Full Name	Mark Idstrom
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	9100 W 74th St, Shawnee Mission, Kansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639264443
Provider Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 8224013016
Enrollment ID: I20040624000406

Medical Identifiers

Medical identifiers for Mark Idstrom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639264443	NPI	-	NPPES
15144081	Other		BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	R2J97 (Missouri)	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. Mark Idstrom allows following entities to bill medicare on his behalf.

Entity Name	The Curators Of The University Of Missouri
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235126921 PECOS PAC ID: 4486759560 Enrollment ID: O20070418000290

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. Mark Idstrom 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
Mark Idstrom, MD 9212 Nieman Rd, Overland Park, KS 66214-1868 Ph: (913) 599-6777	Mark Idstrom, MD 9100 W 74th St, Shawnee Mission, KS 66204-4004 Ph: (913) 676-2310

Reviews and Comments

Radiology Doctors in Shawnee Mission, KS

Michael J Gaughan, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2310
John Yungmeyer, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2310
Jeffrey A Hicklin, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2310
Richard D Miller, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2310
Miss Kavita Chowdary Gorantla, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2310
Michael W Dennis, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-676-2310
Mark S Reinsel, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 9100 W 74th St, Shawnee Mission, KS 66204 Phone: 913-599-6777

Mark Idstrom, MD - Medicare Radiology in Shawnee Mission, KS