Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Idstrom, MD

Individual provider Diagnostic Radiology Physician · NPI 1639264443

Mark Idstrom, MD is a Diagnostic Radiology in Shawnee Mission, Kansas. Graduated from University of Minnesota Medical School in 1975, 51 years ago. Practices with The Curators of the University of Missouri, a 1,093-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
51
Trained at
University of Minnesota Medical School
Licensed in
MO
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

9100 W 74th St
Shawnee Mission, KS 66204-4004
Phone: (913) 676-2310
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence R2J97 (MO)

Record details

NPI number1639264443
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 4, 2006
Last updated in NPPESJuly 8, 2007
Mailing address9212 Nieman Rd, Overland Park, KS 66214-1868

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 1975 (51 years in practice)
Group practice The Curators Of The University Of Missouri — 1093 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Shawnee Mission