First and foremost I understand that stalls happen and patience is required. I'm only 4.5 months post so I know my journey is unlikely to have stopped this early.

That being said I'm at a weight I've gotten to before when I've been successful with dieting. Twice prior to surgery I was able to lose 40-50lbs and get down to right around 200lbs and then that's typically when I started to regain. So I do think this is a bit of a set point for my body. Is there anything to do in a stall beyond waiting it out? Increasing protein, decreasing carbs? Or is it best to just stay the course and let my body do it's thing?

I think it's extra frustrating being so close to one-derland and not being able to get over the tipping point. ?

Yes, stalls are normal, and sometimes it's best to just let them take their course, but you can also try to "mix it up" a bit. Try to eat a bit more for a few days, or increase carbs, drink more water, change your exercise routine. Try taking your measurements instead of your weight for a few weeks to see if that makes you feel better. If you're always eating the same thing for breakfast, try something different. I don't know why, but sometimes changing things helps us get going.

Also, track your calories for a few days to see if you're really eating what you think you are (you will have to weigh/measure all your food to do this right).