MARIO GERARD MASSULLO (D.O.) – Cardiovascular Disease Physician, NPI 1043228158
Cardiovascular Disease Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
131 CARDIAC SURGERY in IL
Provider Addresses for MARIO GERARD MASSULLO (D.O.)
3800 W 203rd St Ste 202
Olympia Fields, IL 604611185
Phone: (708) 852-2699
Fax: (708) 679-2223
Type: Location
100 Provena Way Ste C
Bourbonnais, IL 609144798
Phone: (815) 936-3200
Fax: (815) 936-3203
Type: Location
West Court Street, Kankakee, Kankakee County, Illinois, 60901, United States
KANKAKEE, IL 60901
Phone: (815) 936-3200
Fax: (815) 936-3203
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 113 Open Payments records for all available years, with a total value of $3,736.
Total Amount is formed as General ($3,736) + Research ($0) + Ownership ($0) = $3,736.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Cook Incorporated ($1,035).
Total Amount
$3,736
General + Research + Ownership
Payments
113
Total payment records
General Amount
$3,736
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Cook Incorporated | $1,035 |
| Edwards Lifesciences Corporation | $304 |
| Abbott Laboratories | $290 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $208 |
| Merck Sharp & Dohme LLC | $158 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040519000182 | I | Cardiac Surgery | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,196 | 501 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 522 | 379 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 510 | 173 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 475 | 411 | $0 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 263 | 247 | $0 |
Insurance plans in this area (ZIP 60461)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| Internal Medicine, Gastroenterology | IN | |
| Internal Medicine | IL | |
| Family Practice | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | IL | |
| Internal Medicine | IL | |
| Family Practice | IL | |
| Internal Medicine, Emergency Medicine | MI | |
| Family Practice, Emergency Medicine | IL |
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