Individual provider Active NPI

Lyman Lansing Hale IV, M.D., M.S.

  • Surgery Physician
  • Shiloh, IL
National Provider Identifier
1619298940
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036139253 Issued in IL
Practice address
1414 Cross St Ste 330
Shiloh, IL 62269-2988
Phone
(618) 277-7400
NPI assigned
Jun 22, 2010
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT197334 PA
Surgery Physician 208600000X 036139253 IL Primary

Addresses

Primary practice location

1414 Cross St Ste 330
Shiloh, IL 62269-2988

Mailing address

1414 Cross St Ste 330
Shiloh, IL 62269-2988
Phone (618) 277-7400

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
I20151105000663 IL Practitioner - General Surgery 8628226024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians
Lincoln Surgical Associates, LTD.Group PAC ID 9335320597, 25 clinicians

Practice addresses (Care Compare)

12860 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2810

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600

1414 Cross St
Shiloh, IL 62269-2941
Phone (618) 277-7400

1512 N Green Mount Rd
Suite 108
Ofallon, IL 62269-1953
Phone (618) 624-5510

9409 Holy Cross Lane
Suite 113
Breese, IL 62230-3510
Phone (618) 526-8430

9515 Holy Cross Lane
Breese, IL 62230-3618
Phone (618) 526-4511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy35
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)14
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Apr 14, 2025 Accepting new patients
SJL Health Systems Inc CurrentSince Apr 14, 2025 Accepting new patients
Lincoln Surgical Associates, LTD. Surgery CurrentSince Feb 24, 2023 Accepting new patients
HSHS Prairie, Inc Current Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

1414 Cross St
Ste 330
Shiloh, IL 62269
Phone (618) 228-8610

Interoperability endpoints

  • Direct secure messaging: lhale113096@ewd.direct.hshs.org

Organizations & group practices 5

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1619298940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 330",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692988",
            "telephone_number": "618-277-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 330",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692988",
            "telephone_number": "618-277-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "LYMAN",
        "middle_name": "LANSING",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT197334",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036139253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

Verify at the official NPI Registry.