Active NPI
Caitlin Mae Mechtly, MD
- Internal Medicine Physician
- Iowa City, IA
National Provider Identifier
1063962090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- R-13099
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242-1009 - Phone
- (319) 384-7093
- Fax
- (319) 384-8955
- NPI assigned
- Oct 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60662668 | WA | |
| Internal Medicine Physician | 207R00000X | R-13099 | IA | Primary |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242-1009
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 384-7093
Other practice location 1
2675 E Lincoln Ave
Sunnyside, WA 98944-2485
Phone (509) 839-7030
Other names 1
- Caitlin Mae Robertson
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240813000865 | IA | Order and Referring Only - Internal Medicine | 6901344670 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60662668 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1063962090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-384-7093",
"fax_number": "319-384-8955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-384-7093",
"fax_number": "319-384-8955"
}
],
"practiceLocations": [
{
"address_1": "2675 E Lincoln Ave",
"address_purpose": "LOCATION",
"city": "Sunnyside",
"state": "WA",
"postal_code": "989442485",
"country_code": "US",
"telephone_number": "509-839-7030",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MECHTLY",
"first_name": "CAITLIN",
"middle_name": "MAE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-13",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60662668",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "R-13099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAITLIN",
"last_name": "ROBERTSON",
"middle_name": "MAE",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.