Active NPI 1366424061 Individual Practitioner Male Practitioner

Dr. Douglas Craig Maibenco , MD PHD

Surgery • Decatur, IL

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Maibenco, MD PHD is a registered healthcare professional specializing in Surgery in Decatur, IL. Practice services are available at 1730 E LAKE SHORE DR under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least, biopsy of large bowel using an endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1730 E Lake Shore Dr

Decatur, IL 625213809

Telephone 2173291000

Fax 2173291055

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Decatur, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 22.1 Yrs

State Avg: 27.3 Yrs

Regional Practice Density

18 Specialists

Practicing in Decatur, IL (1624 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.0% 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 (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	91	80	$141.14	$87.67
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	76	69	$83.76	$54.29
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	66	32	$138.86	$78.74
45380 Biopsy of large bowel using an endoscope	53	53	$950.92	$167.56
99231 Follow-up hospital inpatient care per day, typically 15 minutes	47	25	$76.11	$49.79
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	44	44	$1174.00	$90.35
99202 New patient office or other outpatient visit, typically 20 minutes	44	44	$137.00	$70.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$203.56	$110.03
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	31	31	$264.48	$129.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	27	$205.84	$124.88
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	15	15	$1048.60	$241.55
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	13	13	$773.00	$183.02
45378 Diagnostic exam of large bowel using a flexible endoscope	12	12	$1353.00	$182.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	193	60	$138.00	$70.36
99213 Established patient office or other outpatient visit, typically 15 minutes	112	98	$135.00	$88.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	104	98	$81.00	$54.09
99202 New patient office or other outpatient visit, typically 20 minutes	92	92	$137.00	$71.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$203.00	$109.18
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	67	64	$1174.00	$93.95
45380 Biopsy of large bowel using an endoscope	65	65	$923.00	$178.85
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	65	56	$201.00	$123.85
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	47	46	$264.00	$134.03
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	37	33	$271.00	$174.35
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	33	15	$198.00	$100.76
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	30	30	$977.00	$248.40
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	28	28	$773.00	$178.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$313.00	$155.97
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	25	$387.00	$195.76
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	19	19	$773.00	$180.83
38525 Biopsy or removal of lymph nodes of under the arm, open procedure	17	17	$1495.00	$246.97
38900 Lymph node imaging during surgery	17	17	$491.00	$146.78
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	14	14	$390.00	$218.88
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	13	13	$4013.00	$324.02
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	13	13	$219.00	$18.62
19301 Partial removal of breast	13	11	$1591.00	$649.53
49505 Repair of groin hernia (5 years or older)	12	12	$1792.00	$492.85
45378 Diagnostic exam of large bowel using a flexible endoscope	12	12	$1353.00	$184.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	299	105	$138.00	$71.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	151	135	$81.00	$55.04
99213 Established patient office or other outpatient visit, typically 15 minutes	145	121	$135.00	$89.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	109	109	$203.00	$110.54
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	102	99	$264.00	$135.79
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	98	94	$1174.00	$100.60
99202 New patient office or other outpatient visit, typically 20 minutes	94	94	$137.00	$70.95
45380 Biopsy of large bowel using an endoscope	91	91	$923.00	$166.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	75	$201.00	$127.42
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	44	44	$977.00	$235.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$313.00	$164.18
99231 Follow-up hospital inpatient care per day, typically 15 minutes	35	20	$76.00	$38.30
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	30	30	$773.00	$188.70
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	30	30	$773.00	$189.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	25	24	$271.00	$179.89
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	24	$387.00	$199.69
38900 Lymph node imaging during surgery	16	16	$491.00	$143.95
45378 Diagnostic exam of large bowel using a flexible endoscope	15	15	$1353.00	$187.89
38525 Biopsy or removal of lymph nodes of under the arm, open procedure	14	14	$1495.00	$242.84
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	14	14	$390.00	$210.39
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	13	13	$1013.00	$85.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	225	84	$138.00	$72.98
99213 Established patient office or other outpatient visit, typically 15 minutes	202	155	$135.00	$74.21
99202 New patient office or other outpatient visit, typically 20 minutes	117	117	$137.00	$75.10
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	94	89	$264.00	$139.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	66	64	$81.00	$44.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	53	46	$201.00	$107.76
45380 Biopsy of large bowel using an endoscope	51	50	$923.00	$143.67
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	49	47	$1174.00	$106.71
99231 Follow-up hospital inpatient care per day, typically 15 minutes	45	28	$76.00	$39.79
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	26	26	$773.00	$188.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$203.00	$103.25
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	26	26	$977.00	$259.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$313.00	$159.31
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	22	22	$773.00	$192.23
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	18	18	$1013.00	$91.76
38900 Lymph node imaging during surgery	14	14	$491.00	$153.44
45381 Injection beneath lining of large bowel using a flexible endoscope	13	13	$1571.00	$30.46
38525 Biopsy or removal of lymph nodes of under the arm, open procedure	13	13	$1495.00	$282.40
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	12	12	$4013.00	$344.90
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	12	12	$219.00	$19.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	231	171	$135.00	$72.26
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	221	92	$138.00	$72.67
99231 Follow-up hospital inpatient care per day, typically 15 minutes	189	88	$76.00	$39.45
99202 New patient office or other outpatient visit, typically 20 minutes	176	176	$137.00	$74.14
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	100	96	$264.00	$135.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	89	87	$81.00	$43.32
45380 Biopsy of large bowel using an endoscope	79	79	$923.00	$193.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	79	79	$203.00	$105.57
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	71	67	$1174.00	$109.61
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	62	62	$773.00	$187.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	47	$201.00	$104.94
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	36	36	$977.00	$261.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	31	31	$313.00	$161.92
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	30	29	$1013.00	$86.68
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	27	26	$4013.00	$315.52
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	20	20	$219.00	$18.89
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	20	20	$387.00	$202.15
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	19	19	$773.00	$186.92
45378 Diagnostic exam of large bowel using a flexible endoscope	18	18	$1353.00	$192.64
19301 Partial removal of breast	17	17	$1591.00	$676.07
49560 Repair of incisional or abdominal hernia	15	15	$2563.00	$699.77
38525 Biopsy or removal of lymph nodes of under the arm, open procedure	15	15	$1495.00	$255.75
49505 Repair of groin hernia (5 years or older)	14	14	$1792.00	$463.73
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$195.00	$101.89
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	12	12	$2628.00	$745.81
76937 Ultrasonic guidance for blood vessel access	11	11	$41.00	$14.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	283	91	$138.00	$71.83
99213 Established patient office or other outpatient visit, typically 15 minutes	240	185	$135.00	$68.36
99202 New patient office or other outpatient visit, typically 20 minutes	168	168	$137.00	$72.70
99231 Follow-up hospital inpatient care per day, typically 15 minutes	90	50	$75.58	$38.93
45380 Biopsy of large bowel using an endoscope	86	85	$923.00	$181.53
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	83	77	$81.00	$41.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	79	$201.00	$104.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	77	77	$203.00	$105.03
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	63	58	$1174.00	$99.15
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	52	49	$264.00	$135.62
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	47	47	$773.00	$188.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$313.00	$160.84
99221 Initial hospital inpatient care per day, typically 30 minutes	31	30	$195.00	$100.85
45378 Diagnostic exam of large bowel using a flexible endoscope	26	26	$1353.00	$179.63
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	24	24	$38.00	$20.49
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	23	23	$198.00	$99.99
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	23	23	$977.00	$257.17
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	16	$387.00	$200.90
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	16	$1013.00	$90.87
49505 Repair of groin hernia (5 years or older)	16	16	$1792.00	$498.15
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	15	15	$773.00	$189.92
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	14	14	$4013.00	$334.64
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	14	14	$219.00	$18.03
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	12	$271.00	$133.59
38525 Biopsy or removal of lymph nodes of under the arm, open procedure	13	12	$1495.00	$281.53
19301 Partial removal of breast	12	12	$1591.00	$635.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	278	208	$135.00	$70.08
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	257	97	$138.00	$70.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	121	101	$201.00	$102.88
99231 Follow-up hospital inpatient care per day, typically 15 minutes	102	48	$76.00	$38.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	96	96	$313.00	$159.52
99202 New patient office or other outpatient visit, typically 20 minutes	94	94	$137.00	$71.97
45380 Biopsy of large bowel using an endoscope	80	79	$1433.35	$167.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	75	75	$203.00	$104.55
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	73	72	$264.00	$133.76
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	67	65	$1174.00	$106.90
99221 Initial hospital inpatient care per day, typically 30 minutes	60	58	$195.00	$100.59
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	24	24	$773.00	$189.11
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	23	23	$773.00	$177.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	21	$81.00	$41.60
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	18	18	$1013.00	$115.65
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	18	17	$1636.56	$250.81
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	14	14	$2628.00	$732.56
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	13	13	$219.00	$18.92
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	13	13	$4013.00	$333.30
76937 Ultrasonic guidance for blood vessel access	13	13	$70.00	$14.37
49505 Repair of groin hernia (5 years or older)	13	13	$1792.00	$469.34

Medical Specialties & State Licenses

CMS Verified: 2022-01-06

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IL 036098825

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036098825 (IL)

Commercial Insurance / Payer ID Medicare Travelers

CI8411

Practice Associates & Co-Workers

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

13 Associated Practitioners

Dr. Micheal Young , MD

Surgery

NPI 1033214994

Doctor of Medicine (M.D.)

Dr. Jignesh Modi , MD

Internal Medicine - Infectious Disease

NPI 1184935074

Doctor of Medicine (M.D.)

Dr. Manoj Kohli , MD

Internal Medicine - Rheumatology

NPI 1215948146

Doctor of Medicine (M.D.)

Dr. Wael Otaibi , DO

Surgery

NPI 1255452124

Doctor of Osteopathic Medicine (D.O.)

Emily Artime , PA

Physician Assistant

NPI 1255560629

Physician Assistant

Dr. Aftab Jafri , MD

Surgery

NPI 1255696605

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

11 Historical Events

📍

Updated Practice Location January 06, 2022

Registered at 1730 E LAKE SHORE DR, DECATUR, IL 625213809 (Tel: 2173291000)

📍

Updated Business Mailing Address January 06, 2022

Registered at 1730 E LAKE SHORE DR, DECATUR, IL 625213809 (Tel: 2173291000)

📍

Updated Practice Location December 12, 2018

Registered at 1770 E LAKE SHORE DR STE 105, DECATUR, IL 625213800 (Tel: 2173291000)

📍

Updated Business Mailing Address December 12, 2018

Registered at 1770 E LAKE SHORE DR STE 105, DECATUR, IL 625213800 (Tel: 2173291000)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 12, 2018

Surgery (License #036098825 in IL)

✅

NPI Profile Active October 26, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location October 26, 2007

Registered at 1750 E LAKE SHORE DR, STE 200, DECATUR, IL 625213809 (Tel: 2174286300)

📍

Updated Business Mailing Address October 26, 2007

Registered at 1750 E LAKE SHORE DR, STE 200, DECATUR, IL 625213809 (Tel: 2174286300)

👤

Provider Name / Credentials Updated October 26, 2007

Recorded as DOUGLAS MAIBENCO, MD PHD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2007

Surgery

🟢

Initial NPI Registration & Enumeration November 17, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1366424061

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 17, 2005

Last Update: January 06, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1730 E Lake Shore Dr

Decatur, IL 625213809

Phone: 2173291000

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.