LISA A KOWALSKI M.D.
NPI 1295766772
Surgery in Effingham, IL

Active since July 05, 2006PECOS EnrolledAccepts Medicare Assignment
300 N MAPLE ST, EFFINGHAM, IL 62401(217) 342-4151(217) 347-3033 Get Directions Write a Review

NPPES record last updated: May 21, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 21, 2020, Dec 23, 2015 (2 updates tracked since 2015).

About Lisa A Kowalski M.d. NPPES

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

LISA A KOWALSKI M.D. (NPI 1295766772) is an individual surgery provider in Effingham, Illinois, licensed in Illinois (036095601) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and is a graduate of Southern Illinois University School Of Medicine (1992).

NPPES Registry Identity

NPI1295766772
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameLISA A KOWALSKICredential: M.D.
Location Address300 N MAPLE STEffingham, IL 62401-2003
Mailing Address1025 S SixthSpringfield, IL 62703 · (217) 528-7541 · Fax (217) 528-8962
Fax(217) 347-3033
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 1992
Enumeration DateJuly 5, 2006
Last NPPES UpdateMay 21, 20202 updates tracked since enumeration
NPPES CertifiedMay 21, 2020
NPI 1295766772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in IL · 036095601
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
300 N MAPLE ST, Effingham, IL 62401

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Lisa A Kowalski M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022079581
PECOS Enrollment IDI20100108000778
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 15

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 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.
144 services44 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
72 services72 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
43 services43 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
35 services34 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
35 services35 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
34 services19 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Anthonys Memorial Hospital

Acute Care Hospitals · Effingham, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140032
Location503 N Maple StreetEffingham, IL 62401 · Effingham County
Emergency services Birthing friendly

Hshs Holy Family Hospital Inc

Acute Care Hospitals · Greenville, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140137
Location200 Health Care DrGreenville, IL 62246 · Bond County
Emergency services

Memorial Medical Center

Acute Care Hospitals · Springfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140148
Location701 N First StSpringfield, IL 62702 · Sangamon County
Emergency services Birthing friendly

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140189
Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County
Emergency services Birthing friendly

Hshs Good Shepherd Hospital Inc

Critical Access Hospitals · Shelbyville, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141354
Location200 S Cedar StShelbyville, IL 62565 · Shelby County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62401 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 (Cardiovascular Disease)
300 N MAPLE ST
EFFINGHAM, IL 62401
Nurse Practitioner (Family)
300 N MAPLE ST
EFFINGHAM, IL 62401
Internal Medicine
300 N MAPLE ST
EFFINGHAM, IL 62401
Clinic/Center (Rural Health)
300 N MAPLE ST
EFFINGHAM, IL 62401
Dermatology
300 N MAPLE ST
EFFINGHAM, IL 62401
Surgery
300 N MAPLE ST
EFFINGHAM, IL 62401
Nurse Practitioner (Family)
300 N MAPLE ST
EFFINGHAM, IL 62401
Nurse Practitioner (Family)
300 N MAPLE ST
EFFINGHAM, IL 62401

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 Lisa Kowalski's NPI number?

The NPI number for Lisa Kowalski is 1295766772. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Where is Lisa Kowalski located?

Lisa Kowalski practices at 300 N Maple St, Effingham, IL 62401. The listed phone number is (217) 342-4151.

What is Lisa Kowalski's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Lisa Kowalski enrolled in Medicare?

Yes. Lisa Kowalski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lisa Kowalski accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Lisa Kowalski as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lisa Kowalski affiliated with any hospitals?

According to CMS data, Lisa Kowalski is affiliated with St Anthonys Memorial Hospital, Hshs Holy Family Hospital Inc, Memorial Medical Center, Sarah Bush Lincoln Health Center and Hshs Good Shepherd Hospital Inc.

When was this NPI record last updated?

The NPPES record for Lisa Kowalski was last updated on May 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.