NPIMap

Individual provider Active NPI

Maksim Blidchenko, ARNP

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1013559178
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A156720 Issued in IA
Practice address
411 Laurel St Ste A250
Des Moines, IA 50314-3029
Phone
(515) 235-5000
Fax
(515) 288-6713
NPI assigned
Oct 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A156720 IA Primary

Addresses

Primary practice location

411 Laurel St Ste A250
Des Moines, IA 50314-3029

Mailing address

PO Box 9170
Des Moines, IA 50306-9170
Phone (515) 235-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200129000081 IA Practitioner - Nurse Practitioner 1456787191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives-Iowa Corp 111 clinicians

Practice addresses (Care Compare)

1816 Philadelphia St
Ames, IA 50010-8771
Phone (515) 232-2500

411 Laurel St
Suite 1225
Des Moines, IA 50314-3017
Phone (515) 633-3770

5880 University Ave
West Des Moines, IA 50266-8209
Phone (515) 633-3600

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083
  • Pella Regional Health Center Hospital, Pella, IA, CCN 161367
  • Cass County Memorial Hospital Hospital, Atlantic, IA, CCN 161376
  • Mercyone Newton Medical Center Hospital, Newton, IA, CCN 160032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives-Iowa Corp CurrentSince Jan 12, 2020 Accepting new patients
Catholic Health Initiatives-Iowa Corp Nurse Practitioner CurrentSince Jan 12, 2020 Accepting new patients
Iowa Heart Center PC Past Accepting new patients

Locations

1816 Philadelphia St
Ames, IA 50010
Phone (515) 232-2500

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

411 Laurel St
Ste A250
Des Moines, IA 50314
Phone (515) 235-5000

Interoperability endpoints

  • Direct secure messaging: maksim.blidchenko.p1@direct.iowaheart.nextgenshare.com
  • Direct secure messaging: mblidchenko3964158@direct.trinity-health.org

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1013559178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9170",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503069170",
            "telephone_number": "515-235-5000",
            "fax_number": "515-288-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE A250",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143029",
            "telephone_number": "515-235-5000",
            "fax_number": "515-288-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIDCHENKO",
        "first_name": "MAKSIM",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A156720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.