Individual provider Active NPI

Hal Aaron Lewis, M.D.

  • Dermatology Physician
  • Carbondale, IL
National Provider Identifier
1124554209
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036154695 Issued in IL
Practice address
1400 Financial Park
Carbondale, IL 62902-7537
Phone
(618) 351-9140
Fax
(618) 351-9143
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2018013216 MO
Dermatology Physician 207N00000X 036154695 IL Primary

Addresses

Primary practice location

1400 Financial Park
Carbondale, IL 62902-7537

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

1 Barnes Jew Hosp Plz
Saint Louis, MO 63110
Phone (314) 362-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hlewis50646@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810000875 IL Practitioner - Dermatology 5890067250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Columbia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 Financial Park Dr
Carbondale, IL 62901
Phone (618) 351-9140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision75
Removal of tissue1-10
Removal of skin lesions3536
Removal or shaving of skin growth47
Skin biopsy645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036154695ILMDDermatology Physician
2018013216MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Aug 30, 2021 Accepting new patients

Locations

1400 Financial Park
Carbondale, IL 62902
Phone (618) 351-9140

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1124554209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FINANCIAL PARK",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629027537",
            "telephone_number": "618-351-9140",
            "fax_number": "618-351-9143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jew Hosp Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "63110",
            "country_code": "US",
            "telephone_number": "314-362-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "HAL",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2018013216",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036154695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hlewis50646@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1400 Financial Park",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629027537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.