Individual provider Active NPI

James David Hall, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Weston, WI
National Provider Identifier
1972693018
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
56151-20 Issued in WI
Practice address
3301 Cranberry Blvd
Weston, WI 54476-5216
Phone
(715) 393-3900
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X G084053 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036128462 IL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 56151-20 WI Primary

Addresses

Primary practice location

3301 Cranberry Blvd
Weston, WI 54476-5216

Mailing address

3301 Cranberry Blvd
Weston, WI 54476-5216
Phone (715) 393-3900

Other identifiers 3

IdentifierTypeStateIssuer
00G840530MedicaidCA
036128462MedicaidIL
1972693018MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI, IA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110919000754 IL Practitioner - Thoracic SurgeryPractitioner - Cardiac SurgeryPractitioner - Vascular Surgery 8527961648 Reassigns benefits to 3 organizations
I20111026000828 WI Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 8527961648 Reassigns benefits to 1 organization
I20230626000516 IA Practitioner - Thoracic Surgery 8527961648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Chicago, Pritzker School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G084053CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036128462ILMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jun 1, 2018 Accepting new patients
Carle Health Care Incorporated CurrentSince Nov 10, 2022 Accepting new patients
Rockford Health Physicians CurrentSince Nov 1, 2021 Accepting new patients
Carle West Physician Group Inc CurrentSince Jan 27, 2023 Accepting new patients
Medical Associates Clinic P C CurrentSince May 30, 2023 Accepting new patients
Providence Medical Institute Past Accepting new patients

Locations

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

3803 Spring St
Ste 410
Mount Pleasant, WI 53405
Phone (262) 631-8700

3803 Spring St
Ste 400
Mount Pleasant, WI 53405
Phone (262) 687-8208

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 6

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

Hospital & facility affiliations 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1972693018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765216",
            "telephone_number": "715-393-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765216",
            "telephone_number": "715-393-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G084053",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036128462",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "56151-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G840530",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036128462",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972693018",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.