AJA LYSTILA (MD) – Family Medicine Physician, NPI 1215159744

AJA LYSTILA (MD) is a healthcare provider. based in Urbana, Illinois. specializing in FAMILY PRACTICE, EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 036119163 (IL). The NPI Number for AJA LYSTILA (MD) is 1215159744

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
AJA LYSTILA (MD)
NPI
1215159744
Phone
(217) 383-6792
Address
611 W. PARK ST.
Enumeration Date
3 May 2007
Last Update Date
9 March 2015

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2172585900
Graduation Year
2005 (21 years ago)
PAC ID
3577641133
Group Practice PAC ID
3577456037
Professional Enrollment ID
I20080422000791
Address ID
IL619389200MA2512XDRXX306
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,037 FAMILY PRACTICE in IL

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Provider Addresses for AJA LYSTILA (MD)

  • Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States

    BWPC

    URBANA, IL 618012500

    Phone: (217) 383-6792

    Fax: (217) 258-5904

    Type: Mailing

  • Hurst Drive, Mattoon, Coles County, Illinois, United States

    FAMILY MEDICINE

    MATTOON, IL 619389388

    Phone: (217) 258-5900

    Fax: (217) 258-5904

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2008-04-22

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080422000791IFamily PracticeILTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
85610Blood test, clotting time13313$0
G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and2519$0
View full utilization report →

Insurance plans in this area (ZIP 61801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577456037View full group profile
NameSpecialtyState
Internal Medicine, HospitalistIL
Nurse PractitionerIL
Internal Medicine, Family PracticeIL
-IL
Hospitalist, Internal MedicineIL
Nurse PractitionerIL
Internal MedicineIL
Internal Medicine, Cardiovascular Disease (Cardiology)IL
Physician AssistantIL
General SurgeryIL

Reviews

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Frequently asked questions

Can I cross-check AJA LYSTILA (MD) using NPI 1215159744?
NPI 1215159744 belongs to AJA LYSTILA (MD); compare other details if you need extra assurance.
Would AJA LYSTILA (MD) appear as active to a payer?
You can treat AJA LYSTILA (MD) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to AJA LYSTILA (MD)?
AJA LYSTILA (MD)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is AJA LYSTILA (MD) associated with Urbana?
Public fields place AJA LYSTILA (MD) around Urbana, Illinois. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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