Audra Leigh Poterucha, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO-05052 Issued in IA

Practice address

640 S 19TH St Ste 100
Nevada, IA 50201-2902

Phone

(515) 382-5413

Fax

(515) 382-7107

NPI assigned

Jun 17, 2016

Last updated

Jul 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Story County HospitalGroup PAC ID 0547153884, shared by 5 NPIs, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suncrest Hospice, LLC Hospice, West Des Moines, IA, CCN 161608
• Story County Hospital Hospital, Nevada, IA, CCN 161333
• Mary Greeley Medical Center Hospital, Ames, IA, CCN 160030
• Story County Hospital Nursing home, CCN 16Z333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apoterucha412444@direct.unitypoint.org

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

• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD
• Story County Hospital

  dba Nevada Medical Clinic

  • Family Medicine Physician
  • Nevada, IA
  • NPI 1023080504
  Medicare reassignment NPD
• Story County Hospital

  dba Story County Medical Center

  • Critical Access Hospital
  • Nevada, IA
  • NPI 1215054713
  Medicare reassignment NPD
• Broadlawns Medical Center

  • Pharmacy
  • Des Moines, IA
  • NPI 1013197060
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Mary Greeley Medical Center

  • General Acute Care Hospital
  • Ames, IA
  • NPI 1477539492
  Care Compare affiliation
• Story County Hospital

  dba Story County Medical Center

  • Critical Access Hospital
  • Nevada, IA
  • NPI 1215054713
  Care Compare affiliation
• Story County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Nevada, IA
  • NPI 1922335322

  Nursing home

  Care Compare affiliation
• Suncrest Hospice, LLC

  • Community Based Hospice Care Agency
  • West Des Moines, IA
  • NPI 1417350265
  Care Compare affiliation

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1033569223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S 19TH ST STE 100",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502012902",
            "telephone_number": "515-382-5413",
            "fax_number": "515-382-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S 19TH ST STE 100",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502012902",
            "telephone_number": "515-382-5413",
            "fax_number": "515-382-7107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Hickman Rd",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503141505",
            "country_code": "US",
            "telephone_number": "515-282-5640",
            "fax_number": "515-282-2332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 1st St",
            "address_purpose": "LOCATION",
            "city": "Maxwell",
            "state": "IA",
            "postal_code": "501617700",
            "country_code": "US",
            "telephone_number": "515-387-8815",
            "fax_number": "515-387-8817",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 S 19th St",
            "address_purpose": "LOCATION",
            "city": "Nevada",
            "state": "IA",
            "postal_code": "502012902",
            "country_code": "US",
            "telephone_number": "515-382-2111",
            "fax_number": "515-382-7760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTERUCHA",
        "first_name": "AUDRA",
        "middle_name": "LEIGH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "DO-05052",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Overstake, LMSW
• Adrian L Palar, MD
• Rachel Palen, DPT
• Jamie L Peters, DPT
• Laurie Lizabeth Pieper, ARNP-C
• Jamie Ann Rabe, PT
• Samantha Nicole Randall
• Perry Scott Rathe, MD
• David K. Rebarcak, DC
• Katherine Linn Reiter, MAOT OTRL

• Family Medicine Physician in Nevada, IA
• Providers in Nevada, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.

Verify at the official NPI Registry.