MARK IDSTROM MD
NPI 1639264443
Radiology - Diagnostic Radiology in Shawnee Mission, KS

Active since October 04, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
9100 W 74TH ST, SHAWNEE MISSION, KS 66204(913) 676-2310 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mark Idstrom Md NPPES

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

MARK IDSTROM MD (NPI 1639264443) is an individual diagnostic radiology provider in Shawnee Mission, Kansas, licensed in Missouri (R2J97) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Boone Hospital Center, and is a graduate of University Of Minnesota Medical School (1975).

NPPES Registry Identity

NPI1639264443
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameMARK IDSTROMCredential: MD
Location Address9100 W 74TH STShawnee Mission, KS 66204-4004
Mailing Address9212 Nieman RdOverland Park, KS 66214-1868 · (913) 599-6777 · Fax (913) 599-3955
Sole ProprietorNo
Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1975
Enumeration DateOctober 4, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1639264443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in MO · R2J97
Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

9100 W 74TH ST, Shawnee Mission, KS 66204

Other Identifiers 5

Medicare ID-Type UnspecifiedJ040304C
Medicare ID-Type UnspecifiedJ010304
Medicare ID-Type UnspecifiedJ040304B
Other15144081Bcbs
Medicare UPINC95073

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

Mark Idstrom Md 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 ID8224013016
PECOS Enrollment IDI20040624000406
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 9

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ct scan of abdomen and pelvis with contrast 74177
A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
40 services39 patients
X-ray of abdomen, 1 view 74018
An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.
29 services27 patients
Complete ultrasound scan behind abdominal cavity 76770
A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.
28 services28 patients
Imaging for evaluation of swallowing function 74230
This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.
21 services21 patients
Ultrasound study of arm and leg arteries 93922
An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
21 services21 patients
Ultrasound of both sides of head and neck blood flow 93880
An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
20 services20 patients

Hospital Affiliations CMS Care Compare 2

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

Boone Hospital Center

Acute Care Hospitals · Columbia, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260068
Location1600 E BroadwayColumbia, MO 65201 · Boone County
Emergency services Birthing friendly

University Of Missouri Health Care

Acute Care Hospitals · Columbia, MO
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number260141
LocationOne Hospital DriveColumbia, MO 65212 · Boone County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 66204 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
$81.98 typical visit price
range $53.00 – $161.67
Typical copayment $20.49 (range $13.25 – $40.41)
Most-billed visit code 99203
Established Patient
$66.40 typical visit price
range $16.88 – $132.11
Typical copayment $16.60 (range $4.22 – $33.02)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
9100 W 74TH ST
SHAWNEE MISSION, KS 66204
Pharmacist
9100 W 74TH ST, SMMC - PHARMACY
MERRIAM, KS 66204
Pharmacist
9100 W 74TH ST
SHAWNEE MISSION, KS 66204
Pharmacist
9100 W 74TH ST, PHARMACY DEPARTMENT
SHAWNEE MISSION, KS 66204
Pharmacist
9100 W 74TH ST
SHAWNEE MISSION, KS 66204
Psychologist
9100 W 74TH ST
SHAWNEE MISSION, KS 66204
Anesthesiology
9100 W 74TH ST
SHAWNEE MISSION, KS 66204
Nurse Anesthetist, Certified Registered
9100 W 74TH ST
SHAWNEE MISSION, KS 66204

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639264443, enumerated as an "individual" on October 04, 2006.

The provider is located at 9100 W 74TH ST SHAWNEE MISSION, KS 66204 and the phone number is (913) 676-2310.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.

Mark Idstrom is affiliated with: BOONE HOSPITAL CENTER and UNIVERSITY OF MISSOURI HEALTH CARE.