LYLE D PAHNKE JR. MD
NPI 1770538225
Surgery - Vascular Surgery in Centralia, IL

Q: What is Lyle Pahnke's NPI number?

The NPI number for Lyle Pahnke is 1770538225. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Q: What is Lyle Pahnke's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Q: When was this NPI record last updated?

The NPPES record for Lyle Pahnke was last updated on April 15, 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.

Active since May 23, 2006PECOS EnrolledAccepts Medicare Assignment

400 N PLEASANT AVE, CENTRALIA, IL 62801(618) 436-6318(618) 436-6386 Get Directions Write a Review

NPPES record last updated: April 15, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 15, 2022, Nov 29, 2017 (2 updates tracked since 2017).

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About Lyle D Pahnke Jr. Md NPPES

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

LYLE D PAHNKE JR. MD (NPI 1770538225) is an individual vascular surgery provider in Centralia, Illinois, licensed in Illinois (036089773) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and maintains a secondary practice location in Mount Vernon.

NPPES Registry Identity

NPI1770538225

Entity TypeIndividualMale

Primary Taxonomy2086S0129X

Provider Legal NameLYLE D PAHNKE JR.Credential: MD

Location Address400 N PLEASANT AVECentralia, IL 62801-3056

Mailing Address400 N Pleasant AveCentralia, IL 62801-3056 · (618) 436-6318 · Fax (618) 436-6386

Phone(618) 436-6318

Fax(618) 436-6386

Sole ProprietorNo

Medical School CMSOtherGraduated 1970

Enumeration DateMay 23, 2006

Last NPPES UpdateApril 15, 20222 updates tracked since enumeration

NPPES CertifiedApril 15, 2022

✔ NPI 1770538225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

License✔ Licensed in IL · 036089773

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 036089773 (IL)

Also ListedSurgeryTaxonomy 208600000X · License 036089773 (IL)

400 N PLEASANT AVE, Centralia, IL 62801

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Secondary Practice Location 1

Location 1302 Broadway StMount Vernon, IL 62864-5116 · Phone (618) 242-4750 · Fax (618) 242-7674

Other Identifiers 4

Other207988IL · Group

OtherCG2264IL · Rr Group Number

OtherP00169541IL · Rr Medicare Number

Medicaid036089773IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lyle D Pahnke Jr. Md 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 ID9931162302

PECOS Enrollment IDI20041105001094

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.

Medicare Billing Reassignments

Medicare enrollment records show Lyle Pahnke reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Mary's Hospital, Centralia, Illinois

Same address

Anesthesiology

400 N PLEASANT AVE
Centralia, IL 62801

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: St Marys Hospital Centralia Illinois
392 clinicians in this Medicare group

NPI 1477097871 (618) 436-6056

Physician Services Corporation Of Southern Illinois Inc.

17 mi

Internal Medicine

4218 LINCOLNSHIRE DR
Mount Vernon, IL 62864

Reassigned Medicare billing, Illinois enrollment
296 clinicians in this Medicare group

NPI 1831101807 (618) 899-3600

Good Samaritan Regional Health Center

18 mi

Specialist

1 GOOD SAMARITAN WAY
Mount Vernon, IL 62864

Reassigned Medicare billing, Illinois enrollment
284 clinicians in this Medicare group

NPI 1134457955 (618) 899-4600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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 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.

173 services66 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

169 services53 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.

157 services56 patients

Removal of skin and tissue, each additional 20.0 sq cm or less 11045

This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.

30 services13 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.

25 services25 patients

Application of chemical to stop tissue regrowth in wound 17250

This procedure involves applying a special chemical to a wound to prevent unwanted tissue from growing back. It aids in proper healing by ensuring only healthy tissue regrows. It's a common, safe practice in wound care.

19 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Mary's Hospital -Centralia

Acute Care Hospitals · Centralia, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140034

Location400 North Pleasant AvenueCentralia, IL 62801 · Marion County

Emergency services

Good Samaritan Regional Hlth Center

Acute Care Hospitals · Mount Vernon, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140046

Location1 Good Samaritan WayMount Vernon, IL 62864 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62801 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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers15 claims15 services$111.65 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers18 claims18 services$174.93 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.

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