Individual provider Active NPI

Ken L Cheyne, MD

  • Pediatric Adolescent Medicine Physician
  • Des Moines, IA
National Provider Identifier
1053305086
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
23873 Issued in IA
Practice address
1212 Pleasant St
Suite 406
Des Moines, IA 50309-1453
Phone
(515) 241-8336
Fax
(515) 241-6465
NPI assigned
Sep 6, 2005
Last updated
Nov 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 23873 IA Primary

Addresses

Primary practice location

1212 Pleasant St
Suite 406
Des Moines, IA 50309-1453

Mailing address

1212 Pleasant St
Suite 406
Des Moines, IA 50309-1453
Phone (515) 241-8336

Other identifiers 3

IdentifierTypeStateIssuer
1053305086MedicaidIA
53506OtherMEDICARE
1053305086MedicaidMO

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
I20100818000824 IA Practitioner - Pediatric Medicine 8224162839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Iowa Hospital CorporationGroup PAC ID 1052229275, 233 clinicians

Practice addresses (Care Compare)

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6435

1206 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6465

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
83.65
Promoting interoperability
78
Improvement activities
40
Cost
76.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23873IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Apr 1, 1996 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Central Iowa Hospital Corporation Current Accepting new patients
Central Iowa Hospital Corporation CurrentSince Apr 1, 1996 Accepting new patients

Locations

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1200 Pleasant St
Rm 236
Des Moines, IA 50309
Phone (515) 241-6228

1212 Pleasant St
Ste 406
Des Moines, IA 50309
Phone (515) 241-8336

1215 Pleasant St
Ste 500
Des Moines, IA 50309
Phone (515) 241-3560

Interoperability endpoints

  • Direct secure messaging: kcheyne9356@direct.unitypoint.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1053305086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT ST",
            "address_2": "SUITE 406",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-8336",
            "fax_number": "515-241-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT ST",
            "address_2": "SUITE 406",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-8336",
            "fax_number": "515-241-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEYNE",
        "first_name": "KEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IA",
            "license": "23873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053305086",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "53506",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053305086",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.