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State University of Iowa

Organization Active NPI Family Medicine Physician · Iowa City, IA

NPI 1013241850 · NPPES record last updated Dec 9, 2015

Key facts

NPI
1013241850
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
STATE UNIVERSITY OF IOWA
Practice address
1632 Sycamore St
Iowa City, IA 52240-6044
Phone
(319) 384-8822
Fax
(319) 354-1002
NPI assigned
Sep 28, 2009
Organization subpart
No

Authorized official

Name
Philip E Roudabush
Title
Director, Patient Financial Service
Phone
(319) 384-2334

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031107000060 IA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2,348 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

1632 Sycamore St
Iowa City, IA 52240-6044

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1007

Other names

  • UI QuickCare - East Doing business as

Other providers in Iowa City, IA

All providers in Iowa City, IA · Family Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.