MARY WIRTH – Gerontology Nurse Practitioner, NPI 1164395562

MARY WIRTH is a healthcare provider. based in Schaumburg, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209033159 (IL). The NPI Number for MARY WIRTH is 1164395562

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
MARY WIRTH
NPI
1164395562
Phone
(847) 605-9500
Address
812 E Woodfield Rd
Enumeration Date
24 September 2025
Last Update Date
24 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8476059500
Graduation Year
2025 (1 year ago)
PAC ID
8628565710
Group Practice PAC ID
6103983176
Professional Enrollment ID
I20251013004068
Address ID
IL601734776SC804XXRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness85
Years active:0State licenses:1Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for MARY WIRTH

  • 812 E Woodfield Rd

    Schaumburg, IL 601734838

    Phone: (847) 605-9500

    Type: Location

  • 802 E Woodfield Rd Ste 200

    Schaumburg, IL 601734713

    Phone: (847) 605-9500

    Type: Location

  • 3595 WATERSCAPE TER

    ELGIN, IL 601245715

    Phone: (224) 465-2631

    Type: Mailing

  • 804 E WOODFIELD RD STE 300

    SCHAUMBURG, IL 601734776

    Phone: (847) 605-9500

    Fax: (847) 605-8700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-10-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251013004068INurse PractitionerILTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60173)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103983176View full group profile
NameSpecialtyState
Nurse PractitionerIL
Cardiovascular Disease (Cardiology)IL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)IL
Nurse PractitionerIL
Cardiovascular Disease (Cardiology)IL
Cardiovascular Disease (Cardiology)IL
Physician AssistantIL
Nurse PractitionerIL
Nurse PractitionerIL
Cardiovascular Disease (Cardiology), Nuclear Medicine, Interventional CardiologyIL

Reviews

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Frequently asked questions

Is MARY WIRTH listed with a National Provider Identifier?
Yes — MARY WIRTH has NPI 1164395562 on file in the registry.
Active or inactive — what applies to MARY WIRTH?
You should see MARY WIRTH as active in CMS-hosted NPPES data.
What clinical focus is listed for MARY WIRTH?
At a glance, MARY WIRTH is tied to Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with MARY WIRTH?
Directory geography for MARY WIRTH centers on Schaumburg, Illinois.
Does MARY WIRTH accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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