MARK IDSTROM MD NPI 1639264443

NPI Information

  • NPI: 1639264443
  • Provider Name: MARK IDSTROM, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 9100 W 74TH ST
    SHAWNEE MISSION, KS
    ZIP 66204
  • Phone: (913) 676-2310

Map and Directions

Get Directions

NPI Details

Mark Idstrom, MD is a diagnostic radiology radiology in Shawnee Mission, KS with 51 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Mark Idstrom, MD NPI is 1639264443. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year:1975

The provider's business location address is:

9100 W 74TH ST
SHAWNEE MISSION, KS
ZIP 66204-004
Phone: (913) 676-2310

The NPI 1639264443 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • X-ray of abdomen, 1 view (HCPCS:74018)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Imaging for evaluation of swallowing function (HCPCS:74230)
  • Ultrasound study of arm and leg arteries (HCPCS:93922)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)

The enumeration date for this NPI number is 10/4/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyR2J97MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1J040304CMEDICARE ID-TYPE UNSPECIFIED
2J010304MEDICARE ID-TYPE UNSPECIFIED
3J040304BMEDICARE ID-TYPE UNSPECIFIED
415144081OTHERBCBS
5C95073MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI