MR. EDDIE LYNN PAULK (D.O.) – Internal Medicine Physician, NPI 1003813601
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,828 INTERNAL MEDICINE in IL
Provider Addresses for MR. EDDIE LYNN PAULK (D.O.)
6810 STATE ROUTE 162 BOX 215
MARYVILLE, IL 620628501
Phone: (618) 391-6405
Fax: (618) 288-4088
Type: Mailing
6812 STATE ROUTE 162 STE 21
MARYVILLE, IL 620628565
Phone: (618) 288-5566
Fax: (618) 288-4005
Type: Location
2090 VADALABENE DRIVE
SPRINGFIELD, IL 62062
Phone: (618) 288-5403
Fax: (618) 288-6857
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $516.
Total Amount is formed as General ($516) + Research ($0) + Ownership ($0) = $516.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($194).
Total Amount
$516
General + Research + Ownership
Payments
28
Total payment records
General Amount
$516
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-11-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171129000036 | I | Internal Medicine | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20 | 20 | $0 |
Insurance plans in this area (ZIP 62062)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| General Surgery | IL | |
| - | IL | |
| - | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| General Surgery | IL | |
| - | IL | |
| Family Practice | MO | |
| Family Practice | IL |
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