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DENISE M. MAMMOLITO M.D. NPI 1972604221


NPI Information

NPI: 1972604221
Provider Name: DENISE M. MAMMOLITO, M.D.
Classification: Surgery - 208600000X
Entity Type: Individual
Organization: SPRINGFIELD CLINIC LLP

PECOS Registration: Yes

Address:
1001 MAIN STREET
3RD FLOOR
PEORIA, IL
ZIP 61606
Phone: (309) 495-0250
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Denise M. Mammolito, M.D. is a surgery in Peoria, IL with 40 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Denise M. Mammolito, M.D. NPI is 1972604221. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1001 MAIN STREET
3RD FLOOR
PEORIA, IL
ZIP 61606-037
Phone: (309) 495-0250
Fax: (309) 676-6545

The NPI 1972604221 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.

  • Partial removal of breast (HCPCS:19301)
  • Lymph node imaging during surgery (HCPCS:38900)

The enumeration date for this NPI number is 9/26/2006 and was last updated on 10/14/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery036082251ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E80760MEDICARE UPINILLINOIS
2036082251MEDICAIDILLINOIS
37215166OTHERILLINOISBCBS OF ILLINOIS
4K35445OTHERILLINOISMEDICARE ID, TYPE UNSPEC

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: 11/14/2023

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.