Individual provider Active NPI

Neetha Molakala, M.D.

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1003070921
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39219 Issued in IA
Practice address
1200 University Ave
Suite 120
Des Moines, IA 50314-2343
Phone
(515) 248-1500
Fax
(515) 248-1510
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39219 IA Primary
Student in an Organized Health Care Education/Training Program 390200000X R8274 IA

Addresses

Primary practice location

1200 University Ave
Suite 120
Des Moines, IA 50314-2343

Mailing address

9943 Hickman Rd
Suite 105
Urbandale, IA 50322-5304
Phone (515) 248-1447

Other practice location 1

1410 SW Tradition Dr Ste 110
Ankeny, IA 50023-9188
Phone (515) 875-9696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110826000650 IA Practitioner - Family Practice 8820268980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1410 SW Tradition Dr
Suite 110
Ankeny, IA 50023-9188
Phone (515) 875-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8274IAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC CurrentSince Mar 15, 2019 Accepting new patients
The Iowa Clinic PC Family Medicine CurrentSince Mar 15, 2019 Accepting new patients

Locations

1410 SW Tradition Dr
Ste 110
Ankeny, IA 50023
Phone (515) 875-9696

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1003070921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9943 HICKMAN RD",
            "address_2": "SUITE 105",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503225304",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE",
            "address_2": "SUITE 120",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142343",
            "telephone_number": "515-248-1500",
            "fax_number": "515-248-1510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 SW Tradition Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500239188",
            "country_code": "US",
            "telephone_number": "515-875-9696",
            "fax_number": "515-875-9697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLAKALA",
        "first_name": "NEETHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "39219",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "R8274",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.