Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MARIO GERARD MASSULLO D.O.
NPI 1043228158
Internal Medicine - Cardiovascular Disease in Kankakee, IL

Active since August 04, 2006PECOS Enrolled
1710 W. COURT ST., KANKAKEE, IL 60901(815) 936-3200(815) 936-3203 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 20, 2026, Oct 8, 2021, Jul 8, 2019 and 1 more (4 updates tracked since 2018).

About Mario Gerard Massullo D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIO GERARD MASSULLO D.O. (NPI 1043228158) is an individual cardiovascular disease provider in Kankakee, Illinois, licensed in Illinois (036082059) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Carle Foundation Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1043228158
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameMARIO GERARD MASSULLOCredential: D.O.
Location Address1710 W. COURT ST.Kankakee, IL 60901
Mailing Address1710 W Court StKankakee, IL 60901-3160 · (815) 936-3200
Fax(815) 936-3203
Sole ProprietorYes
Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 1988
Enumeration DateAugust 4, 2006
Last NPPES UpdateJuly 20, 20264 updates tracked since enumeration
NPPES CertifiedJuly 20, 2026
NPI 1043228158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in IL · 036082059
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X · License 036082059 (IL)
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License 036082059 (IL)
1710 W. COURT ST., Kankakee, IL 60901

Secondary Practice Locations 2

Location 13800 W 203rd St Ste 202Olympia Fields, IL 60461-1185 · Phone (708) 852-2699 · Fax (708) 679-2223
Location 2100 Provena Way Ste CBourbonnais, IL 60914-4798 · Phone (815) 936-3200 · Fax (815) 936-3203

Other Identifiers 1

Medicaid036082059IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mario Gerard Massullo D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577554690
PECOS Enrollment IDI20040519000182
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 24

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,157 services497 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
588 services427 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
367 services129 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
364 services318 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
281 services270 patients
Blood test, clotting time 85610
A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
234 services19 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carle Foundation Hospital

Acute Care Hospitals · Urbana, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140091
Location611 West Park StreetUrbana, IL 61801 · Champaign County
Emergency services Birthing friendly

Presence St Marys Hospital

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140155
Location500 W Court StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Riverside Medical Center

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140186
Location350 N Wall StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Iroquois Memorial Hospital

Critical Access Hospitals · Watseka, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141353
Location200 Fairman StreetWatseka, IL 60970 · Iroquois County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
78%439 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
2%122 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
20%710 patients1/55-star benchmark: 100%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
2%321 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mario Massullo's NPI number?

The NPI number for Mario Massullo is 1043228158. It was assigned to this individual provider in the NPPES registry on August 4, 2006.

Where is Mario Massullo located?

Mario Massullo practices at 1710 W. Court St., Kankakee, IL 60901. The listed phone number is (815) 936-3200.

What is Mario Massullo's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Mario Massullo enrolled in Medicare?

Yes. Mario Massullo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Mario Massullo affiliated with any hospitals?

According to CMS data, Mario Massullo is affiliated with Carle Foundation Hospital, Presence St Marys Hospital, Riverside Medical Center and Iroquois Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mario Massullo was last updated on July 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.