Individual provider Active NPI

Eric D Haugen, MD

  • Pediatrics Physician
  • Des Moines, IA
National Provider Identifier
1063406940
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35075 Issued in IA
Practice address
1212 Pleasant St
Suite 300
Des Moines, IA 50309-1453
Phone
(515) 241-8923
Fax
(515) 241-8728
NPI assigned
Sep 7, 2005
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35075 IA Primary

Addresses

Primary practice location

1212 Pleasant St
Suite 300
Des Moines, IA 50309-1453

Mailing address

1212 Pleasant St
Suite 300
Des Moines, IA 50309-1453
Phone (515) 241-8923

Other identifiers 3

IdentifierTypeStateIssuer
1063406940MedicaidIA
209917806MedicaidMO
42068045213MedicaidNE

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
I20040223001089 IA Practitioner - Pediatric Medicine 8426944968 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Aug 1, 2003 Accepting new patients
Trinity Regional Medical Center CurrentSince Jun 14, 2022 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 Aug 1, 2003 Accepting new patients
Boone County Hospital Past 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 300
Des Moines, IA 50309
Phone (515) 241-6000

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

Interoperability endpoints

  • Direct secure messaging: ehaugen9877@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Unitypoint Clinic Pediatrics Fort DodgeFort Dodge, IA, CCN 168603 Rural health clinic Contracted Managing Employee
Operational/Managerial Control
May 1, 2022
May 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1063406940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT ST",
            "address_2": "SUITE 300",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-8923",
            "fax_number": "515-241-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT ST",
            "address_2": "SUITE 300",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-8923",
            "fax_number": "515-241-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "ERIC",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "35075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063406940",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209917806",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42068045213",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.