Maurice Deon Dale

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036170338 Issued in IL

Practice address

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099

Phone

(618) 234-2120

NPI assigned

Mar 30, 2021

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

93.41 of 100Reported as group

Quality

86.81

Improvement activities

40

Cost

77.34

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdale1188064@direct.unitypoint.org

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.

• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment NPD
• Memorial Hospital Association

  • Critical Access Hospital
  • Carthage, IL
  • NPI 1730139031
  Medicare reassignment NPD
• Schuyler County Hospital District

  • Critical Access Hospital
  • Rushville, IL
  • NPI 1013969112
  Medicare reassignment NPD
• Central Prairie Physicians PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1821884750

  IL

  Medicare reassignment NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Greenville, IL
  • NPI 1225537137
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Memorial Hospital Association

  dba Women & Family Medical Group

  • Rural Health Clinic/Center
  • Carthage, IL
  • NPI 1205887742
  NPD
• Memorial Hospital Association

  dba Memorial Medical Clinic Broadway

  • Rural Health Clinic/Center
  • Hamilton, IL
  • NPI 1679327779
  NPD
• Schuyler County Hospital District

  dba Community Medical Clinic of Table Grove

  • Rural Health Clinic/Center
  • Table Grove, IL
  • NPI 1194223719
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1639757958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9515 Holy Cross Ln",
            "address_purpose": "LOCATION",
            "city": "Breese",
            "state": "IL",
            "postal_code": "622303618",
            "country_code": "US",
            "telephone_number": "618-526-5325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12866 Troxler Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "IL",
            "postal_code": "622492806",
            "country_code": "US",
            "telephone_number": "618-651-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALE",
        "first_name": "MAURICE",
        "middle_name": "DEON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036170338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shambra Cullum, APN
• Maria Louise Cunningham, LPT
• Christian Elias Czech, FNP-C
• Dominique C D'Souza, MD
• Josef Dabrowski
• Nicholas Kester Dane, BEHAVIOR TECHNICIAN
• Jessica W Daniel, OTD, OTR/L
• Brandon Michael Daniels, DC
• David N. Pfohl, MD, LLC (dba ELDERMED SERVICES)
• Tess David

• Emergency Medicine Physician in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.