DOUGLAS CRAIG MAIBENCO MD PHD NPI 1366424061

NPI Information

  • NPI: 1366424061
  • Provider Name: DOUGLAS CRAIG MAIBENCO, MD PHD
  • Classification: Surgery - 208600000X
  • Entity Type: Individual
  • Address: 1730 E LAKE SHORE DR
    DECATUR, IL
    ZIP 62521
  • Phone: (217) 329-1000

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NPI Details

Douglas Craig Maibenco, MD PHD is a surgery in Decatur, IL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Douglas Craig Maibenco, MD PHD NPI is 1366424061. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1730 E LAKE SHORE DR
DECATUR, IL
ZIP 62521-809
Phone: (217) 329-1000
Fax: (217) 329-1055

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Biopsy or removal of deep lymph nodes of underarm (HCPCS:38525)
  • Imaging of lymph nodes during surgery (HCPCS:38900)
  • New patient office or other outpatient visit, 60-74 minutes (HCPCS:99205)
  • Fluoroscopic guidance for insertion or removal of central vein access device (HCPCS:77001)
  • Partial removal of breast (HCPCS:19301)
  • Insertion of central venous tube with port (5 years or older) (HCPCS:36561)
  • Repair of groin hernia (5 years or older) (HCPCS:49505)
  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)

The enumeration date for this NPI number is 11/17/2005 and was last updated on 1/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgery036098825ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036098825MEDICAIDILLINOIS
2CI8411OTHERMEDICARE TRAVELERS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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