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


Quality Rating: 100 out of 100 score

NPI Status: Active since October 04, 2006

Contact Information

9100 W 74TH ST
SHAWNEE MISSION, KS
ZIP 66204
Phone: (913) 676-2310

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  • Individual
  • Male
  • Years of Experience 51
  • Radiology
  • Diagnostic Radiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARK IDSTROM

This page provides the complete NPI Profile along with additional information for Mark Idstrom, a provider established in Shawnee Mission, Kansas with a medical specialization in Radiology, focusing in diagnostic radiology and more than 51 years of experience. He graduated from University Of Minnesota Medical School in 1975. The healthcare provider is registered in the NPI registry with number 1639264443 assigned on October 2006. The practitioner's primary taxonomy code is 2085R0202X with license number R2J97 (MO). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1639264443
Provider Name
MARK IDSTROM MD
Gender
Male
Entity Type
Individual
Location Address
9100 W 74TH ST SHAWNEE MISSION, KS 66204
Location Phone
(913) 676-2310
Mailing Address
9212 NIEMAN RD OVERLAND PARK, KS 66214
Mailing Phone
(913) 599-6777
Mailing Fax
Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year
1975
Is Sole Proprietor?
No
Enumeration Date
10-04-2006
Last Update Date
07-08-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
R2J97
License State
MO
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 9200 (+ Incentives) - EPO
  • Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
  • Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Bronze 4 - HMO
  • Bronze 8 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO
  • Silver 9 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
J040304CMEDICARE ID-TYPE UNSPECIFIED (04) 
J010304MEDICARE ID-TYPE UNSPECIFIED (04) 
J040304BMEDICARE ID-TYPE UNSPECIFIED (04) 
15144081OTHER (01)BCBS
C95073MEDICARE UPIN (02) 

Medicare Participation & PECOS Enrollment Status

Mark Idstrom is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Mark Idstrom is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8224013016

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040624000406

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complete ultrasound scan behind abdominal cavity

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.

This service was performed 28 times for 28 patients

Ct scan of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

This service was performed 40 times for 39 patients

Imaging for evaluation of swallowing function

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.

This service was performed 21 times for 21 patients

Limited ultrasound scan of abdomen

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

This service was performed 17 times for 17 patients

Ultrasound of both sides of head and neck blood flow

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.

This service was performed 20 times for 20 patients

Ultrasound study of arm and leg arteries

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.

This service was performed 21 times for 21 patients

Ultrasound study of arm or leg veins with compression and maneuvers

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.

This service was performed 16 times for 16 patients

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

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.

This service was performed 15 times for 15 patients

X-ray of abdomen, 1 view

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

This service was performed 29 times for 27 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.49 for a new patient copayment and $16.6 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 66204 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.98
  • Minimum New Patient Price $53
  • Maximum New Patient Price $161.67
  • Average New Patient Copayment $20.49
  • Minimum New Patient Copayment $13.25
  • Maximum New Patient Copayment $40.41

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.4
  • Minimum Established Patient Price $16.88
  • Maximum Established Patient Price $132.11
  • Average Established Patient Copayment $16.6
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $33.02

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 100 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: N/A

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mark Idstrom is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
BOONE HOSPITAL CENTER1600 E BROADWAY
COLUMBIA, MO 65201
(573) 815-8000Acute Care Hospitals
UNIVERSITY OF MISSOURI HEALTH CAREONE HOSPITAL DRIVE
COLUMBIA, MO 65212
(573) 882-4141Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1639264443
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
266946848
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 6 + 9 + 4 + 6 + 8 + 4 + 8 + 24 = 77
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 77 = 33

The NPI number 1639264443 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1386641702MR. GREGORY JAN STROHS R.PH.
Individual
Pharmacist9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2284
1083615769DR. DWIGHT KEITH PERKINS PHARM.D.
Individual
Pharmacist9100 W 74TH ST SMMC - PHARMACY
MERRIAM, KS 66204
(913) 676-8106
1255333266MISS KYLA ELIZABETH SHORT PHARM.D.
Individual
Pharmacist9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-6877
1184609281MS. MELANIE BETH GOODNIGHT PHARMD.
Individual
Pharmacist9100 W 74TH ST PHARMACY DEPARTMENT
SHAWNEE MISSION, KS 66204
(913) 676-8107
1790760437DR. HOLLY JEAN RUDER PHARM.D
Individual
Pharmacist9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-8124
1457327801DR. RAVINDRAN SABAPATHY PSY. D
Individual
Psychologist9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2679
1306812227DR. JOHN ROBINSON M.D.
Individual
Anesthesiology9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2679
1104893957 JAY H. KRAENOW CRNA
Individual
Nurse Anesthetist, Certified Registered9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2679
1538136676MRS. MARY J RUFF CRNA
Individual
Nurse Anesthetist, Certified Registered9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2679
1366419301MS. EVONNE LAUSIER CRNA
Individual
Nurse Anesthetist, Certified Registered9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2679
1477505238DR. PATRICK ANGELO LEONI M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-7519
1063432169 MICHAEL J GAUGHAN MD
Individual
Radiology (Diagnostic Radiology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2310
1447365630 ROBERT E MOFFAT MD
Individual
Radiology (Diagnostic Radiology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2310
1548375793 CHARLES A KARLIN MD
Individual
Radiology (Vascular & Interventional Radiology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(916) 676-2310
1104918788MRS. JAMIE M BOATMAN ARNP
Individual
Nurse Practitioner (Gerontology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2679
1265527113 MARK S REINSEL MD
Individual
Radiology (Diagnostic Radiology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 599-6777
1205924867DR. ZIANA A LIESE M.D.
Individual
Family Medicine9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2126
1912095050PATHOLOGISTS PROFESSIONAL ASSOCIATION
Organization
Pathology (Anatomic Pathology & Clinical Pathology)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2000
1962580209MRS. STEPHANIE RENEE LININGER A.R.N.P-C
Individual
Nurse Practitioner (Acute Care)9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-2000
1497890982MRS. ALISON SMITH PHARM.D.
Individual
Pharmacist9100 W 74TH ST
SHAWNEE MISSION, KS 66204
(913) 676-8124

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639264443, enumerated in the NPI registry as an "individual" on October 04, 2006

The provider is located at 9100 W 74th St Shawnee Mission, Ks 66204 and the phone number is (913) 676-2310

The provider's speciality is Radiology with taxonomy code 2085R0202X with a focus in Diagnostic Radiology

The provider has more than 51 years of experience. He graduated from University Of Minnesota Medical School in 1975.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Molina. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $81.98 with an average copayment of $20.49 for new patient appointments. Established patients should expect a typical charge of $66.4 and an average copayment of 16.6. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Complete ultrasound scan behind abdominal cavity, Ct scan of abdomen and pelvis with contrast, Imaging for evaluation of swallowing function, Limited ultrasound scan of abdomen, Ultrasound of both sides of head and neck blood flow, Ultrasound study of arm and leg arteries, Ultrasound study of arm or leg veins with compression and maneuvers, Ultrasound study of one arm or leg veins with compression and maneuvers and X-ray of abdomen, 1 view.

The practitioner is affiliated to the following hospital(s): BOONE HOSPITAL CENTER and UNIVERSITY OF MISSOURI HEALTH CARE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on October 04, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.