LISA MARIE MASCIOLI (APRN, CNP) – Nurse Practitioner, NPI 1639627375
Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for LISA MARIE MASCIOLI (APRN, CNP)
385 WIRTZ DR
DEKALB, IL 601153067
Phone: (815) 306-2777
Fax: (815) 306-2778
Type: Mailing
DEPT 781625
P.O. BOX 78000
DETROIT, MI 482781625
Phone: (614) 355-8004
Fax: (614) 355-2220
Type: Mailing
Nationwide Children's Close To Home Center, 495, East Main Street, East Town Street Historic District, Columbus, Franklin, Ohio, 43215, United States
COLUMBUS, OH 432155349
Phone: (614) 355-8005
Fax: (614) 355-8030
Type: Location
1200 N East St
Olney, IL 624502432
Phone: (618) 395-5222
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $25.
Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.
Last reported payment date: 2023-04-12 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($25).
Total Amount
$25
General + Research + Ownership
Payments
1
Total payment records
General Amount
$25
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $25 |
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: 2023-04-19
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 |
|---|---|---|---|---|
| I20230419002326 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60115)
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