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

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: August 16, 2026.

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
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

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 5

Services this provider delivered to Medicare fee-for-service patients, from the 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 with moderate level of decision making, if using time, 30 minutes or more 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.
1,004 services577 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 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.
164 services139 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 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.
46 services42 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.
39 services39 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 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.
26 services26 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
Quality63.86
Improvement Activities40
Cost56.87

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
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.

Internal Medicine
304 W HAY ST, STE 312
DECATUR, IL 62526
Durable Medical Equipment & Medical Supplies
304 W HAY ST, SUITE 215
DECATUR, IL 62526
Orthopaedic Surgery (Hand Surgery)
304 W HAY ST, SUITE 215
DECATUR, IL 62526
Orthopaedic Surgery
304 W HAY ST, STE 111
DECATUR, IL 62526
Optometrist
304 W HAY ST, SUITE 311
DECATUR, IL 62526
Orthopaedic Surgery
304 W HAY ST, SUITE 111
DECATUR, IL 62526
Orthopaedic Surgery
304 W HAY ST, SUITE 213
DECATUR, IL 62526
Orthopaedic Surgery
304 W HAY ST, STE 213
DECATUR, IL 62526

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Baumberger's NPI number?

The NPI number for David Baumberger is 1043277064. It was assigned to this individual provider in the NPPES registry on April 26, 2006.

Where is David Baumberger located?

David Baumberger practices at 304 W Hay St Ste 312, Decatur, IL 62526. The listed phone number is (217) 876-5600.

What is David Baumberger's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is David Baumberger enrolled in Medicare?

Yes. David Baumberger is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for David Baumberger was last updated on August 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.