NPIMap

Individual provider Active NPI

Luke Tyler Hall, M.D.

  • Family Medicine Physician
  • Eldorado, IL
National Provider Identifier
1417150376
Registry record updated Jul 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036128470 Issued in IL
Practice address
1407 Locust St
Eldorado, IL 62930
Phone
(618) 273-3361
NPI assigned
Jun 7, 2007
Last updated
Jul 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036128470 IL Primary

Addresses

Primary practice location

1407 Locust St
Eldorado, IL 62930

Mailing address

1201 Pine St
Eldorado, IL 62930-1634
Phone (314) 531-6351

Other identifiers 1

IdentifierTypeStateIssuer
036128470MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180328000422 IL Practitioner - Family Practice 8224202817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Pine St
Eldorado, IL 62930-1634
Phone 61827333611660

1300 US Hwy 45 N
Eldorado, IL 62930-3765

1306 Maple St
Eldorado, IL 62930-1662
Phone (618) 297-9665

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036128470ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ferrell Hospital Community Foundation CurrentSince Jun 18, 2018 Accepting new patients
Ferrell Hospital Community Foundation Past Accepting new patients
Ferrell Hospital Community Foundation Past Accepting new patients

Locations

1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361

1300 US Highway 45 N
Eldorado, IL 62930
Phone (618) 273-9305

Interoperability endpoints

  • Direct secure messaging: lhall194331@direct.deaconess.com

Organizations & group practices 3

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

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531008000000",
    "number": "1417150376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PINE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301634",
            "telephone_number": "314-531-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 LOCUST ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "62930",
            "telephone_number": "618-273-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "LUKE",
        "middle_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2018-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036128470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036128470",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldorado, IL

Sources for this page

Verify at the official NPI Registry.