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

Q: What is Mark Idstrom's NPI number?

The NPI number for Mark Idstrom is 1639264443. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Q: What is Mark Idstrom's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Mark Idstrom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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: October 18, 2026.

On this page

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

Phone(913) 676-2310

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

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Other Identifiers 5

Medicare ID-Type UnspecifiedJ040304C

Medicare ID-Type UnspecifiedJ010304

Medicare ID-Type UnspecifiedJ040304B

Other15144081Bcbs

Medicare UPINC95073

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Mark Idstrom reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Curators Of The University Of Missouri

127 mi

Multi-Specialty

1 HOSPITAL DR
Columbia, MO 65212

Reassigned Medicare billing, Missouri enrollment
1,395 clinicians in this Medicare group

NPI 1235126921 (573) 882-4141

University Of Florida Jacksonville Physicians Inc

950 mi

Nephrology

655 W 8TH ST, UFJP NEPHROLOGY
Jacksonville, FL 32209

Reassigned Medicare billing, Florida enrollment
1,456 clinicians in this Medicare group

NPI 1295995561 (904) 244-3660

Brevard Physician Associates, PLLC

1,093 mi

Vascular & Interventional Radiology

8075 SPYGLASS HILL RD
Melbourne, FL 32940

Reassigned Medicare billing, Florida enrollment
378 clinicians in this Medicare group

NPI 1124691159 (321) 837-3820

Proscan Nch Imaging LLC

1,145 mi

Diagnostic Radiology

24040 S TAMIAMI TRL
Bonita Springs, FL 34134

Reassigned Medicare billing, Florida enrollment
191 clinicians in this Medicare group

NPI 1750972493 (239) 598-0035

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 14

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.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

314 services203 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

130 services123 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

106 services103 patients

X-ray of chest, 2 views 71046

50 services50 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

31 services31 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.

19 services17 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

17 services17 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.

17 services17 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.

17 services17 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.

14 services14 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

14 services14 patients

Ct scan of chest with contrast 71260

12 services12 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

12 services12 patients

Complete ultrasound scan of abdomen 76700

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

11 services11 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 Interoperability

100

Improvement Activities

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.

MRS. MARY SWINGLE CRNA

Nurse Anesthetist, Certified Registered

9100 W 74TH ST
MERRIAM, KS 66204

Johnson County (913) 632-2230

RHEUMATOLOGY SPECIALISTS OF KANSAS CITY PA

Specialist

9100 W 74TH ST
OVERLAND PARK, KS 66204

Johnson County (816) 753-5736

MS. PENNY ANN WALTER RD, LD

Dietitian, Registered

9100 W 74TH ST
SHAWNEE MISSION, KS 66204

Johnson County (913) 676-2195

LORENE CREASSER ARNP

Nurse Practitioner (Family)

9100 W 74TH ST
SHAWNEE MISSION, KS 66204

Johnson County (913) 676-2200

MS. ANN WHEELER BCBA

Behavior Analyst

9100 W 74TH ST
SHAWNEE MISSION, KS 66204

Johnson County (913) 676-2253

TYLER DAVIS DO

Anesthesiology

9100 W 74TH ST
SHAWNEE MISSION, KS 66204

Johnson County (913) 676-2000

ELIZABETH DANIELLE FLESHMAN

Registered Nurse

9100 W 74TH ST
MERRIAM, KS 66204

Johnson County (913) 909-2776

MITCHELL YOUNG

Nurse Anesthetist, Certified Registered

9100 W 74TH ST
MERRIAM, KS 66204

Johnson County (913) 676-2000

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 Mark Idstrom's NPI number?

The NPI number for Mark Idstrom is 1639264443. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Where is Mark Idstrom located?

Mark Idstrom practices at 9100 W 74th St, Shawnee Mission, KS 66204. The listed phone number is (913) 676-2310.

What is Mark Idstrom's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Mark Idstrom enrolled in Medicare?

Yes. Mark Idstrom 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.

Which organizations bill Medicare for Mark Idstrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Idstrom reassigns Medicare benefits to 4 organizations: The Curators Of The University Of Missouri (Columbia, MO), University Of Florida Jacksonville Physicians Inc (Jacksonville, FL), Brevard Physician Associates, PLLC (Melbourne, FL) and Proscan Nch Imaging LLC (Bonita Springs, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Idstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Idstrom accept?

Health plans from Anthem Blue Cross and Blue Shield list Mark Idstrom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mark Idstrom affiliated with any hospitals?

According to CMS data, Mark Idstrom is affiliated with Boone Hospital Center and University Of Missouri Health Care.

When was this NPI record last updated?

The NPPES record for Mark Idstrom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.