DR. JAMES T LAWLER M.D.
NPI 1821353913
Internal Medicine in Marion, IL

Q: What is James Lawler's NPI number?

The NPI number for James Lawler is 1821353913. It was assigned to this individual provider in the NPPES registry on July 5, 2012.

Q: What is James Lawler's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for James Lawler was last updated on August 19, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 05, 2012PECOS EnrolledAccepts Medicare Assignment

85.02/100

CMS Quality Rating

1129 N CARBON ST, STE 2, MARION, IL 62959(618) 518-7700(618) 997-6441 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. James T Lawler M.d. NPPES

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

DR. JAMES T LAWLER M.D. (NPI 1821353913) is an individual internal medicine provider in Marion, Illinois, licensed in Illinois (036138280) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1821353913

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. JAMES T LAWLERCredential: M.D.

Location Address1129 N CARBON ST, STE 2Marion, IL 62959-1068

Mailing AddressPo Box 1763Marion, IL 62959 · (618) 993-0002 · Fax (855) 385-3091

Phone(618) 518-7700

Fax(618) 997-6441

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJuly 5, 2012

Last NPPES UpdateAugust 19, 2022

NPPES CertifiedAugust 19, 2022

✔ NPI 1821353913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036138280

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1129 N CARBON ST, Marion, IL 62959

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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. James T Lawler 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 ID3072746981

PECOS Enrollment IDI20150901002779

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 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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

948 services241 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.

98 services67 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

30 services30 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

23 services22 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.

13 services13 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140164

Location405 W JacksonCarbondale, IL 62901 · Jackson County

Emergency services Birthing friendly

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number140184

Location3333 W DeyoungMarion, IL 62959 · Williamson County

Emergency services

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

St Joseph Memorial Hospital

Critical Access Hospitals · Murphysboro, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141334

Location2 South Hospital DriveMurphysboro, IL 62966 · Jackson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62959 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

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.

85.02/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

81.78

Promoting Interoperability

Improvement Activities

Cost

76.62

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)

Lower rates are better for this measure.

66%58 patients2/55-star benchmark: 100%

Advance Care Plan

2%475 patients1/55-star benchmark: 100%

Breast Cancer Screening

63%211 patients3/55-star benchmark: 93%

Closing the Referral Loop: Receipt of Specialist Report

42%433 patients2/55-star benchmark: 87%

Colorectal Cancer Screening

37%408 patients2/55-star benchmark: 88%

Controlling High Blood Pressure

62%342 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

1%82 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

100%82 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

98%3,121 patients4/55-star benchmark: 100%

e-Prescribing

99%1,844 patients4/55-star benchmark: 100%

HIV Screening

1%269 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

26%682 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

27%779 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 5% · 674 patients

5%674 patients

Provide Patients Electronic Access to Their Health Information

42%484 patients2/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

82%160 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 3% · 434 patients

Patients totalRate: 18% · 482 patients

19%482 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers14 claims40 services$6.28 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

3 suppliers14 claims14 services$17.34 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers13 claims70 services$2.41 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier18 claims18 services$18.36 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 6

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

DR. JAMES T. LAWLER M.D. S.C.

Internal Medicine