DAVID W BAUMBERGER M.D.
NPI 1043277064
Internal Medicine in Decatur, IL

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207R00000X.

Active since April 26, 2006PECOS Enrolled

67.18/100

CMS Quality Rating

304 W HAY ST, STE 312, DECATUR, IL 62526(217) 876-5600(217) 876-5664 Get Directions Write a Review

NPPES record last updated: August 20, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About David W Baumberger M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID W BAUMBERGER M.D. (NPI 1043277064) is an individual internal medicine provider in Decatur, Illinois, licensed in Illinois (036068671) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043277064

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDAVID W BAUMBERGERCredential: M.D.

Location Address304 W HAY ST, STE 312Decatur, IL 62526-6328

Mailing Address2300 N Edward St, GsbllDecatur, IL 62526-4163 · (217) 876-5600 · Fax (217) 876-5664

Phone(217) 876-5600

Fax(217) 876-5664

Sole ProprietorYes

Enumeration DateApril 26, 2006

Last NPPES UpdateAugust 20, 2014

✔ NPI 1043277064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036068671

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

304 W HAY ST, Decatur, IL 62526

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Other Identifiers 1

Medicaid036068671IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David W Baumberger M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 30-39 minutes 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

895 services564 patients

Established patient office or other outpatient visit, 20-29 minutes 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

223 services192 patients

Established patient office or other outpatient visit, 10-19 minutes 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

118 services112 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

38 services33 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

36 services12 patients

Established patient office or other outpatient visit, 40-54 minutes 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

34 services30 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

67.18/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.86

Improvement Activities

Cost

56.87

Referred Medical Equipment & Supplies CMS DME claims 33

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

17 suppliers100 claims236 services$6.05 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

12 suppliers37 claims43 services$1.06 avg. paid by Medicare

Skin barrier; solid, 4 x 4 or equivalent; each A4362

DME-Orthotic Devices · category DF010N

4 suppliers21 claims590 services$2.76 avg. paid by Medicare

Ostomy skin barrier, liquid (spray, brush, etc.), per oz A4369

DME-Orthotic Devices · category DF010N

2 suppliers12 claims44 services$2.35 avg. paid by Medicare

Ostomy skin barrier, powder, per oz A4371

DME-Orthotic Devices · category DF010N

4 suppliers20 claims31 services$3.42 avg. paid by Medicare

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385

DME-Orthotic Devices · category DF010N

5 suppliers20 claims560 services$4.73 avg. paid by Medicare

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394

DME-Orthotic Devices · category DF010N

5 suppliers21 claims360 services$2.48 avg. paid by Medicare

Ostomy skin barrier, non-pectin based, paste, per ounce A4405

DME-Orthotic Devices · category DF010N

2 suppliers11 claims22 services$3.31 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409

DME-Orthotic Devices · category DF010N

3 suppliers14 claims400 services$6.00 avg. paid by Medicare

Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432

DME-Orthotic Devices · category DF010N

3 suppliers14 claims280 services$3.42 avg. paid by Medicare

Tape, waterproof, per 18 square inches A4452

DME-Medical/Surgical Supplies · category DA000N

2 suppliers16 claims920 services$0.34 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

5 suppliers21 claims1,435 services$0.23 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

5 suppliers46 claims46 services$39.09 avg. paid by Medicare

Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each A5057

DME-Orthotic Devices · category DF010N

3 suppliers16 claims300 services$9.08 avg. paid by Medicare

Skin barrier; solid, 6 x 6 or equivalent, each A5121

DME-Orthotic Devices · category DF010N

2 suppliers11 claims220 services$7.21 avg. paid by Medicare

Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6216

DME-Medical/Surgical Supplies · category DA023N

2 suppliers11 claims1,320 services$0.04 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers26 claims26 services$92.69 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers15 claims34 services$35.56 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

3 suppliers19 claims103 services$15.59 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

3 suppliers47 claims47 services$60.00 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers43 claims43 services$20.03 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers13 claims13 services$15.98 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers69 claims310 services$2.28 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

3 suppliers22 claims22 services$12.62 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

3 suppliers70 claims73 services$13.64 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

4 suppliers96 claims99 services$40.44 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

5 suppliers52 claims53 services$94.57 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers28 claims28 services$32.80 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

3 suppliers15 claims1,290 services$0.09 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers32 claims32 services$20.02 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers28 claims28 services$179.76 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

3 suppliers21 claims21 services$33.14 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

4 suppliers17 claims17 services$22.92 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. M STEPHEN HUSS M.D.

Orthopaedic Surgery

304 W HAY ST, STE 213
DECATUR, IL 62526

Macon County (217) 875-1518

DR. EDMUND WILLIAM RAYCRAFT M.D.

Orthopaedic Surgery

304 W HAY ST, SUITE 111
DECATUR, IL 62526

Macon County (217) 872-8200

DR. TYLER NOEL JONES M.D.

Orthopaedic Surgery

304 W HAY ST, STE 111
DECATUR, IL 62526

Macon County (217) 872-8205

DR. SUSAN S WU M.D.

Physical Medicine & Rehabilitation

304 W HAY ST, SUITE 218
DECATUR, IL 62526

Macon County (217) 877-2088

MRS. WENDY E. SALEFSKI OTR/L CHT

Occupational Therapist (Hand)

304 W HAY ST, SUITE 215
DECATUR, IL 62526

Macon County (217) 875-4263

MRS. GRETCHEN M RISER OTR/L CHT

Occupational Therapist (Hand)

304 W HAY ST, SUITE 215
DECATUR, IL 62526

Macon County (217) 875-4263

DR. JEFFERY M SMITH M.D.

Orthopaedic Surgery (Hand Surgery)

304 W HAY ST, SUITE 215
DECATUR, IL 62526

Macon County (247) 875-4263

CENTER FOR SIGHT CENTRAL IL I SC

Optometrist

304 W HAY ST, SUITE 311
DECATUR, IL 62526

Macon County (217) 877-5050

DAVID W BAUMBERGER M.D.
NPI 1043277064
Internal Medicine in Decatur, IL

About David W Baumberger M.d. NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 1

Medicare Participation & PECOS CMS

Medicare Enrollment Status

Areas of Expertise CMS Part B claims 9

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Referred Medical Equipment & Supplies CMS DME claims 33

Other Providers at the Same Location NPPES 20

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