DENISE M. MAMMOLITO (M.D.) – Surgery Physician, NPI 1972604221
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DENISE M. MAMMOLITO (M.D.)
12507 N HICKORY GROVE RD
DUNLAP, IL 615259411
Phone: (309) 696-1085
Type: Mailing
1001, Main Street, Roanoke-Randolph Street Historic District, Peoria, Peoria County, Illinois, 61606, United States
3RD FLOOR
PEORIA, IL 616062037
Phone: (309) 495-0250
Fax: (309) 495-0276
Type: Mailing
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: 2007-03-09
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 |
|---|---|---|---|---|
| I20070309000471 | I | General 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 59 | 56 | $0 |
| 38900 | Imaging of lymph nodes during surgery | 16 | 16 | $0 |
| 19301 | Partial removal of breast | 15 | 15 | $0 |
| 38525 | Biopsy or removal of deep lymph nodes of underarm | 14 | 14 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 61525)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | IL | 19301 | Partial removal of breast | 57 | 51 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | IL | |
| - | IL | |
| Internal Medicine | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Diagnostic Radiology | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | IL |
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