NPIMap

Individual provider Active NPI

Daniel M Hallam, M.D.

  • Surgery Physician
  • Jacksonville, IL
National Provider Identifier
1548479751
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036125699 Issued in IL
Practice address
1600 W Walnut St
Jacksonville, IL 62650-1136
Phone
(217) 528-7541
Fax
(217) 528-7541
NPI assigned
May 22, 2007
Last updated
May 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 036125699 IL
Surgery Physician 208600000X 036125699 IL Primary

Addresses

Primary practice location

1600 W Walnut St
Jacksonville, IL 62650-1136

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address danielhallam@sfc.allscriptsdirect.net

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
I20101115000482 IL Practitioner - General Surgery 9032304175 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Illinois Medical College, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians
Carlinville Area Hospital AssociationGroup PAC ID 9032021373, shared by 6 NPIs, 25 clinicians

Practice addresses (Care Compare)

15 Founders LN
Jacksonville, IL 62650-3919
Phone (217) 291-1041

20733 N Broad St
Carlinville, IL 62626-3710
Phone (217) 854-3141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy170
Hernia repair - groin (open)11
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux114
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036125699ILMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carlinville Area Hospital Association Current Accepting new patients
Carlinville Area Hospital Association CurrentSince May 5, 2017 Accepting new patients
Springfield Clinic, LLP CurrentSince Aug 2, 2010 Accepting new patients
Carlinville Area Hospital Association CurrentSince May 5, 2017 Accepting new patients
Carlinville Area Hospital Association Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carlinville Area Hospital Association Past Accepting new patients

Locations

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

15 Founders Ln
Jacksonville, IL 62650
Phone (217) 243-0300

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

1025 S 6th St
Springfield, IL 62703

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: daniel.hallam.1@28977.direct.athenahealth.com
  • Direct secure messaging: danielhallam@cah.allscriptsdirect.net
  • FHIR API: https://fhir-usa.unify.chbase.com/org/carlin-6115abf3

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Jan 1, 2013
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Jan 1, 2013
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Jan 1, 2013
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Jan 1, 2013
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Jan 1, 2013

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 5

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1548479751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541",
            "fax_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-528-7541",
            "fax_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAM",
        "first_name": "DANIEL",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036125699",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036125699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "danielhallam@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1600 W Walnut St",
            "city": "Jacksonville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "626501136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.