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DR. LYMAN LANSING HALE IV M.D., M.S.
NPI 1619298940
Surgery in Shiloh, IL

Active since June 22, 2010PECOS EnrolledAccepts Medicare Assignment
75.73/100
CMS Quality Rating
1414 CROSS ST STE 330, SHILOH, IL 62269(618) 277-7400 Get Directions Write a Review

NPPES record last updated: March 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 30, 2023, Jan 5, 2021, Apr 30, 2018 (3 updates tracked since 2018).

About Dr. Lyman Lansing Hale Iv M.d., M.s. NPPES

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

DR. LYMAN LANSING HALE IV M.D., M.S. (NPI 1619298940) is an individual surgery provider in Shiloh, Illinois, licensed in Illinois (036139253) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1619298940
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. LYMAN LANSING HALE IVCredential: M.D., M.S.
Location Address1414 CROSS ST STE 330Shiloh, IL 62269-2988
Mailing Address1414 Cross St Ste 330Shiloh, IL 62269-2988 · (618) 277-7400
Phone(618) 277-7400
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJune 22, 2010
Last NPPES UpdateMarch 30, 20233 updates tracked since enumeration
NPPES CertifiedMarch 30, 2023
✔ NPI 1619298940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in IL · 036139253✔ Licensed in PA · MT197334
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.
1414 CROSS ST STE 330, Shiloh, IL 62269
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.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

Dr. Lyman Lansing Hale Iv M.d., M.s. 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 ID8628226024
PECOS Enrollment IDI20151105000663
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 7

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.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
149 services80 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.
88 services87 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.
51 services48 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
34 services34 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 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.
23 services22 patients

Hospital Affiliations CMS Care Compare 4

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

St Josephs Hospital

Acute Care Hospitals · Breese, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140145
Location9515 Holy Cross LnBreese, IL 62230 · Clinton County
Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number141336
Location12866 Troxler AvenueHighland, IL 62249 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62269 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
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.

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.

75.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.09
Promoting Interoperability100
Improvement Activities40
Cost45.26

Referred Medical Equipment & Supplies CMS DME claims 6

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

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
4 suppliers13 claims380 services$6.01 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
4 suppliers17 claims500 services$2.61 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
4 suppliers20 claims620 services$0.21 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix B4197
Other-Enteral and Parenteral · category OB005N
1 supplier11 claims76 services$278.52 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
1 supplier11 claims76 services$7.97 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
1 supplier11 claims76 services$24.90 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 4

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

DEIRDRE HART MD
Colon & Rectal Surgery
1414 CROSS ST STE 330
SHILOH, IL 62269
St. Clair County (618) 277-7400
MICHAEL NORMAN PULSIPHER DO
Surgery
1414 CROSS ST STE 330
SHILOH, IL 62269
St. Clair County (618) 277-7400
DONALD SCOTT CROUCH M.D.
Surgery
1414 CROSS ST STE 330
SHILOH, IL 62269
St. Clair County (618) 277-7400
LINCOLN SURGICAL ASSOCIATES, LTD.
Surgery
1414 CROSS ST STE 330
SHILOH, IL 62269
St. Clair County (618) 277-7400

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 Lyman Hale's NPI number?

The NPI number for Lyman Hale is 1619298940. It was assigned to this individual provider in the NPPES registry on June 22, 2010.

Where is Lyman Hale located?

Lyman Hale practices at 1414 Cross St Ste 330, Shiloh, IL 62269. The listed phone number is (618) 277-7400.

What is Lyman Hale's specialty?

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

Is Lyman Hale enrolled in Medicare?

Yes. Lyman Hale 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 Lyman Hale accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Lyman Hale 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 Lyman Hale affiliated with any hospitals?

According to CMS data, Lyman Hale is affiliated with St Josephs Hospital, Memorial Hospital, Hshs St Elizabeth's Hospital and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Lyman Hale was last updated on March 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.