NPIMap

Individual provider Active NPI

Jeffrey L Hallett, MD

  • Gastroenterology Physician
  • Newburgh, IN
National Provider Identifier
1760499313
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036085584 Issued in IL
Practice address
3800 Venetian Way
Ste 200
Newburgh, IN 47630-8257
Phone
(812) 477-6103
Fax
(812) 477-4897
NPI assigned
Aug 2, 2006
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036085584 IL Primary

Addresses

Primary practice location

3800 Venetian Way
Ste 200
Newburgh, IN 47630-8257

Mailing address

3800 Venetian Way
Newburgh, IN 47630-8257
Phone (812) 469-3283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MT, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100526000942 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 9335278530 Reassigns benefits to 2 organizations
I20230420001647 MT Practitioner - Internal Medicine 9335278530 Reassigns benefits to 2 organizations
I20250611003515 MN Practitioner - Gastroenterology 9335278530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians
Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as apm
Quality
80.39
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy86
Upper gastrointestinal (GI) endoscopy for acid reflux59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036085584ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital CurrentSince May 1, 2025 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 1, 2025 Accepting new patients
Centracare Clinic CurrentSince May 1, 2025 Accepting new patients
Centracare Clinic CurrentSince May 1, 2025 Accepting new patients
Great Falls Clinic LLC CurrentSince Apr 17, 2023 Accepting new patients
Pekin Prohealth Inc CurrentSince Feb 15, 2023 Accepting new patients
St. Cloud Hospital CurrentSince May 1, 2025 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 1, 2025 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Past Accepting new patients

Locations

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

1400 29th St S
Great Falls, MT 59405
Phone (406) 442-3570

3000 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3102

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25095/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jhallett876268@direct.centracare.com

Organizations & group practices 11

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 7

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1760499313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 VENETIAN WAY",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308257",
            "telephone_number": "812-469-3283",
            "fax_number": "812-469-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 VENETIAN WAY",
            "address_2": "STE 200",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308257",
            "telephone_number": "812-477-6103",
            "fax_number": "812-477-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLETT",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-11-10",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036085584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.