Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1174521074 Individual Practitioner Male Practitioner

Dr. Jeffrey Scott Poulter , MD

Plastic Surgery • Bloomington, IL

Professional Overview & Biography Verified Profile Summary

Dr. Jeffrey Poulter, MD is a registered healthcare professional specializing in Plastic Surgery in Bloomington, IL. Practice services are available at 1505 EASTLAND DR under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1505 Eastland Dr
Ste 350

Bloomington, IL 617013534

Telephone 3096631222
Fax 3096630580
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Bloomington, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 35.3 Yrs
State Avg: 24.3 Yrs
Regional Practice Density
5 Specialists

Practicing in Bloomington, IL (236 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
22.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
14 13 $93.00 $71.70

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Surgery - Plastic and Reconstructive Surgery

NUCC Taxonomy Code: 2086S0122X

State License MO MDR5N96

A surgeon who specializes in plastic and reconstructive surgery.

Surgery - Plastic and Reconstructive Surgery

NUCC Taxonomy Code: 2086S0122X

A surgeon who specializes in plastic and reconstructive surgery.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Venkata Dodda , MD

Internal Medicine - Critical Care Medicine

NPI 1013194042

Doctor of Medicine (M.D.)

NPI 1023012614

Doctor of Medicine (M.D.)

Melanie Schall

Pharmacist

NPI 1033264197
Kenneth Inoue

Internal Medicine

NPI 1053403626
Dr. Finn Amble , MD

Otolaryngology

NPI 1063442457

Doctor of Medicine (M.D.)

Caroline Turner , APN

Nurse Practitioner

NPI 1073082384

Advanced Practice Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 19, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location December 19, 2007

Registered at 1505 EASTLAND DR, STE 350, BLOOMINGTON, IL 617013534 (Tel: 3096631222)

📍
Updated Business Mailing Address December 19, 2007

Registered at 1505 EASTLAND DR, STE 350, BLOOMINGTON, IL 617013534 (Tel: 3096631222)

👤
Provider Name / Credentials Updated December 19, 2007

Recorded as JEFFREY POULTER, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 19, 2007

Surgery (License #MDR5N96 in MO)

🟢
Initial NPI Registration & Enumeration July 13, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174521074
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2005
Last Update: December 19, 2007
Sole Proprietor: Yes

Mailing Address

1505 Eastland Dr, Ste 350

Bloomington, IL 617013534

Phone: 3096631222

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.