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DOUGLAS CRAIG MAIBENCO MD PHD
NPI 1366424061
Surgery in Decatur, IL

Active since November 17, 2005
94.61/100
CMS Quality Rating
1730 E LAKE SHORE DR, DECATUR, IL 62521(217) 329-1000(217) 329-1055 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 6, 2022, Dec 12, 2018 (2 updates tracked since 2018).

About Douglas Craig Maibenco Md Phd NPPES

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

DOUGLAS CRAIG MAIBENCO MD PHD (NPI 1366424061) is an individual surgery provider in Decatur, Illinois, licensed in Illinois (036098825) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1366424061
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDOUGLAS CRAIG MAIBENCOCredential: MD PHD
Location Address1730 E LAKE SHORE DRDecatur, IL 62521-3809
Mailing Address1730 E Lake Shore DrDecatur, IL 62521-3809 · (217) 329-1000 · Fax (217) 329-1055
Phone(217) 329-1000
Fax(217) 329-1055
Sole ProprietorNo
Enumeration DateNovember 17, 2005
Last NPPES UpdateJanuary 6, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2022
✔ NPI 1366424061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036098825
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.
1730 E LAKE SHORE DR, Decatur, IL 62521
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Other Identifiers 2

Medicaid036098825IL
OtherCI8411Medicare Travelers

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 10

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

MICHEAL YOUNG M.D.
Surgery
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000
JIGNESH MODI M.D.
Internal Medicine (Infectious Disease)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000
DANXUAN LONG MD
Internal Medicine (Pulmonary Disease)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-1350
MANOJ KOHLI MD
Internal Medicine (Rheumatology)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000
DR. LESLIE STANISLAUS ANEWENAH MD
Surgery
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000
DR. RICHARD ROBERT DILORENZO DO
Internal Medicine (Gastroenterology)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000
KHONDKER ISLAM MD
Internal Medicine (Gastroenterology)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000
LINDSAY MICHELLE HENDERSON
Nurse Practitioner (Family)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 329-1000

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 Douglas Maibenco's NPI number?

The NPI number for Douglas Maibenco is 1366424061. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Where is Douglas Maibenco located?

Douglas Maibenco practices at 1730 E Lake Shore Dr, Decatur, IL 62521. The listed phone number is (217) 329-1000.

What is Douglas Maibenco's specialty?

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

When was this NPI record last updated?

The NPPES record for Douglas Maibenco was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.