Individual provider Active NPI

Mafeth Araula Lim, DO

  • Family Medicine Physician
  • Collinsville, IL
National Provider Identifier
1194284414
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021020850 Issued in MO
Practice address
531 Vandalia St
Collinsville, IL 62234-4061
Phone
(618) 344-0090
Fax
(618) 344-4371
NPI assigned
Mar 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 2021020850 MO Primary

Addresses

Primary practice location

531 Vandalia St
Collinsville, IL 62234-4061

Mailing address

6810 State Route 162
Box 215
Maryville, IL 62062
Phone (618) 391-6495

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
I20240831000175 IL Practitioner - Family Practice 6901202324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

1103 Belt Line Rd
Collinsville, IL 62234-4368
Phone (618) 344-2273

Hospital & facility affiliations

  • Gateway Regional Home Health - Granite City Home health agency, Granite City, IL, CCN 147729
  • Anderson Home Health Services Home health agency, Maryville, IL, CCN 147420
  • Amedisys Home Health Home health agency, O Fallon, IL, CCN 148004
  • Anderson Hospital Hospital, Maryville, IL, CCN 140289

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC Single Specialty CurrentSince Aug 15, 2024 Accepting new patients

Locations

1103 Belt Line Rd
#B
Collinsville, IL 62234
Phone (618) 344-0090

531 Vandalia St
Collinsville, IL 62234
Phone (618) 344-0090

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

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 4

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": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1194284414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-391-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 VANDALIA ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344061",
            "telephone_number": "618-344-0090",
            "fax_number": "618-344-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "MAFETH",
        "middle_name": "ARAULA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-16",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021020850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, IL

Sources for this page

Verify at the official NPI Registry.