Active NPI
Grerk Sutamtewagul, MD
- Hematology & Oncology Physician
- Iowa City, IA
National Provider Identifier
1003103383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- MD-43972
- Practice address
- 200 Hawkins Dr
Dept of Internal Medicine
Iowa City, IA 52242-1009 - Phone
- (319) 356-1616
- Fax
- (319) 353-8383
- NPI assigned
- Jul 7, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | R-09931 | IA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hematology & Oncology Physician | 207RH0003X | MD-43972 | IA | Primary |
Addresses
Primary practice location
200 Hawkins Dr
Dept of Internal Medicine
Iowa City, IA 52242-1009
Mailing address
200 Hawkins Dr
C32Gh
Iowa City, IA 52242-1009
Phone (319) 356-1616
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616
Hospital & facility affiliations
- University of Iowa Hospital & Clinics
- Henry County Health Center
- Southeast Iowa Regional Medical Center
- Washington County Hospital and Clinics
- University of Iowa Health Care Medical Center Down
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.02 of 100
- Quality
- 75.68
- Promoting interoperability
- 78
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-09931 | IA | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State University of Iowa | Current | Accepting new patients | |
| State University of Iowa | Past | Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Locations
200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616
200 Hawkins Dr
#C32
Iowa City, IA 52242
Phone (319) 356-1527
200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616
Interoperability endpoints
- gsutamtewagul67003@uihcdirect.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Iowa City, IA
- NPI 1477554814
-
- Critical Access Hospital
- Charles City, IA
- NPI 1265402390
-
- Student Health Clinic/Center
- Iowa City, IA
- NPI 1285635664
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Mount Pleasant, IA
- NPI 1811571417
-
- General Acute Care Hospital
- West Burlington, IA
- NPI 1134168263
-
- General Acute Care Hospital
- Iowa City, IA
- NPI 1376544320
-
- General Acute Care Hospital
- Iowa City, IA
- NPI 1699541870
-
- Critical Access Hospital
- Washington, IA
- NPI 1053305326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580256000000",
"number": "1003103383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"address_2": "C32GH",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-1616",
"fax_number": "319-353-8383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"address_2": "DEPT OF INTERNAL MEDICINE",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-1616",
"fax_number": "319-353-8383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTAMTEWAGUL",
"first_name": "GRERK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-07",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IA",
"license": "R-09931",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IA",
"license": "MD-43972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.