Individual provider Active NPI

Stephanie Roman

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1063293785
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
131268 Issued in IA
Practice address
1215 Pleasant St Ste 206
Des Moines, IA 50309-1419
Phone
(515) 875-9092
Fax
(515) 875-9828
NPI assigned
Oct 9, 2023
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 131268 IA Primary

Addresses

Primary practice location

1215 Pleasant St Ste 206
Des Moines, IA 50309-1419

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411003134 IA Practitioner - Physician Assistant 7810411774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1005 Pennsylvania Ave
Suite 102a
Ottumwa, IA 52501-6408
Phone (641) 684-2589

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6212

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1000

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 358-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131268IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC Multi-Specialty CurrentSince May 19, 2025 Accepting new patients
The Iowa Clinic, PC CurrentSince May 19, 2025 Accepting new patients

Locations

1215 Pleasant St
Ste 206
Des Moines, IA 50309
Phone (515) 241-5743

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1063293785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 PLEASANT ST STE 206",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091419",
            "telephone_number": "515-875-9092",
            "fax_number": "515-875-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "131268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.