Active NPI 1326109992 Individual Practitioner Female Practitioner

Nicole Dalton , PA

Physician Assistant • Forsyth, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Nicole Dalton, PA is a certified Physician Assistant practicing in Forsyth, IL. With approximately 25 years of clinical experience since completing medical education in 2001, Nicole Dalton delivers high-quality medical care to the local community at 241 W WEAVER RD.

Nicole Dalton is affiliated with Saint James Hospital and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, insertion of needle into vein for collection of blood sample, vaccine for influenza for administration into muscle, 0.5 ml dosage. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

241 W Weaver Rd
Suite 145b

Forsyth, IL 625359762

Telephone 2177945472

Fax 2177945458

Associated Practice Facility / Clinic

🏢 Decatur Memorial Hospital Facility NPI 1609879097

Medicare Profile & Education

Medical School

Other

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Forsyth, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs Matches City Avg

City Avg: 25.0 Yrs

State Avg: 11.7 Yrs

Regional Practice Density

3 Specialists

Practicing in Forsyth, IL (4958 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

65.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Dalton (25 Years) 25 Yrs

Forsyth Specialty Average (25.0 Years) 25.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	42	34	$293.43	$102.63
36415 Insertion of needle into vein for collection of blood sample	16	15	$29.94	$8.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	87	69	$282.00	$103.68
36415 Insertion of needle into vein for collection of blood sample	24	23	$29.00	$8.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	371	240	$270.70	$104.82
36415 Insertion of needle into vein for collection of blood sample	139	118	$27.50	$2.96
99213 Established patient office or other outpatient visit, typically 15 minutes	65	59	$192.22	$74.28
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	59	57	$26.93	$21.05
G0008 Administration of influenza virus vaccine	59	57	$31.86	$28.03
81003 Automated urinalysis test	57	43	$13.56	$2.22
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	18	18	$99.00	$34.82
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	13	12	$287.00	$30.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	336	210	$266.00	$106.83
36415 Insertion of needle into vein for collection of blood sample	146	103	$27.00	$3.00
99213 Established patient office or other outpatient visit, typically 15 minutes	58	52	$178.66	$75.87
81003 Automated urinalysis test	56	40	$13.00	$2.25
G0008 Administration of influenza virus vaccine	44	43	$30.00	$16.21
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	44	43	$26.00	$20.51
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	14	14	$99.00	$35.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	324	201	$254.46	$89.95
36415 Insertion of needle into vein for collection of blood sample	122	96	$27.00	$2.99
81003 Automated urinalysis test	57	44	$13.00	$2.23
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	47	46	$26.00	$19.52
G0008 Administration of influenza virus vaccine	46	45	$29.09	$16.15
99213 Established patient office or other outpatient visit, typically 15 minutes	39	33	$161.31	$62.33
G0009 Administration of pneumococcal vaccine	18	18	$28.56	$16.12
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	18	18	$187.78	$118.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	367	214	$241.78	$88.96
36415 Insertion of needle into vein for collection of blood sample	121	97	$27.00	$2.92
99213 Established patient office or other outpatient visit, typically 15 minutes	97	77	$152.36	$61.14
G0008 Administration of influenza virus vaccine	54	53	$27.91	$15.85
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	54	53	$25.91	$18.65
81002 Urinalysis, manual test	48	38	$25.00	$3.41
81003 Automated urinalysis test	22	19	$13.00	$2.36
G0009 Administration of pneumococcal vaccine	20	19	$27.30	$15.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$244.33	$90.03
90670 Pneumococcal vaccine for injection into muscle	12	12	$326.00	$204.35
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	11	11	$50.00	$7.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	282	172	$235.21	$87.50
99213 Established patient office or other outpatient visit, typically 15 minutes	224	148	$148.05	$59.92
36415 Insertion of needle into vein for collection of blood sample	98	81	$27.00	$2.92
81003 Automated urinalysis test	45	38	$13.00	$2.71
G0008 Administration of influenza virus vaccine	41	41	$26.07	$19.39
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	41	41	$25.00	$18.65
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	21	20	$50.00	$7.86
G0009 Administration of pneumococcal vaccine	16	16	$26.00	$19.39
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	13	13	$158.38	$105.59
81002 Urinalysis, manual test	13	11	$25.00	$3.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	11	$94.50	$35.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	379	203	$228.20	$87.39
99213 Established patient office or other outpatient visit, typically 15 minutes	133	106	$144.26	$59.22
36415 Insertion of needle into vein for collection of blood sample	96	79	$26.30	$2.93
81003 Automated urinalysis test	76	54	$13.00	$3.02
G0008 Administration of influenza virus vaccine	42	40	$25.00	$23.77
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	40	39	$25.00	$18.65
G0009 Administration of pneumococcal vaccine	25	25	$25.00	$23.77
90670 Pneumococcal vaccine for injection into muscle	15	15	$295.00	$186.52
83036 Hemoglobin A1C level	15	13	$56.27	$13.05
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	14	14	$50.00	$7.90
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	13	11	$42.31	$16.11

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085-001647

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medicare Group #

833120

Commercial Insurance / Payer ID Rr Individual #

P00807365

Commercial Insurance / Payer ID Rr Group #

CA2264

Hospital & Practice Group Affiliations

Saint James Hospital

1231 Kleemann Dr, Clinton, IL 617272633

Phone: 2179355022

Practice Associates & Co-Workers

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

12 Associated Practitioners

Dr. Bethany Gebur , DMSC, MPAS, PA-C

Physician Assistant - Medical

NPI 1043737448

Doctor of Medical Science, MPAS, Physician Assistant (Certified)

Dr. Michael Wall , MD

Family Medicine

NPI 1093772311

Doctor of Medicine (M.D.)

Brittney Moutray , RD LDN CDE

Dietitian, Registered

NPI 1114234085

RDLDNCDE

Feras Shawish

Internal Medicine

NPI 1225786882

Dr. Pooja Sheth-Dutt , MD

Family Medicine

NPI 1346735065

Doctor of Medicine (M.D.)

Jane Piraino , NP

Nurse Practitioner

NPI 1457412124

Nurse Practitioner

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active April 28, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location April 28, 2010

Registered at 241 W WEAVER RD, SUITE 145B, FORSYTH, IL 625359762 (Tel: 2177945472)

📍

Updated Business Mailing Address April 28, 2010

Registered at 2300 N EDWARD ST, DECATUR, IL 625264163 (Tel: 2178762868)

👤

Provider Name / Credentials Updated April 28, 2010

Recorded as NICOLE DALTON, P.A.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2010

Physician Assistant (License #085-001647 in IL)

🟢

Initial NPI Registration & Enumeration December 13, 2006

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: 1326109992

Entity Type:

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

Enumeration Date: December 13, 2006

Last Update: April 28, 2010

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2300 N Edward St

Decatur, IL 625264163

Phone: 2178762868

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.