LAKE SHORE UROLOGY AT ST. MARY'S
NPI 1043486731
Urology in Decatur, IL
NPI Status: Active since May 02, 2008
Contact Information
1770 E LAKE SHORE DR
SUITE 202
DECATUR, IL
ZIP 62521
Phone: (217) 464-2505
Fax: (217) 464-1669
- Organization
- Urology
- CLIA Number: 14D2050675
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-03-2026
About LAKE SHORE UROLOGY AT ST. MARY'S
This page provides the complete NPI Profile along with additional information for Lake Shore Urology At St. Mary's, a provider established in Decatur, Illinois operating as a Urology. The healthcare provider is registered in the NPI registry with number 1043486731 assigned on May 2008. The practitioner's primary taxonomy code is 208800000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Lake Shore Urology At St. Mary's. The authorized official of this NPI record is Mark D Evard (Vp Of Revenue Cycle)
- NPI
- 1043486731
- Provider Legal Name
- ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER
- Other Organization Name
- LAKE SHORE UROLOGY AT ST. MARY'S
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1770 E LAKE SHORE DR SUITE 202 DECATUR, IL 62521
- Location Phone
- (217) 464-2505
- Location Fax
- (217) 464-1669
- Mailing Address
- 3051 HOLLIS DR SPRINGFIELD, IL 62704
- Mailing Phone
- (217) 464-2505
- Mailing Fax
- (217) 464-1669
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-02-2008
- Last Update Date
- 10-31-2024
- Code Navigator
Location Map
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
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D2050675
- Facility Type
- Physician Office
- Certificate Effective Date
- December 04, 2024
- Certificate Expiration Date
- December 03, 2026
- Laboratory Director
- CHARMAINE H. MZIRAY-ANDREW M D
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lake Shore Urology At St. Mary's to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1043486731, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DACATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043486731, enumerated as an "organization" on May 02, 2008.
The provider is located at 1770 E LAKE SHORE DR SUITE 202 DECATUR, IL 62521 and the phone number is (217) 464-2505.
Urology with taxonomy code 208800000X.
