Individual provider Active NPI

Holley A Bermel, D.O.

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1083804793
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4031 Issued in IA
Practice address
2301 E 14TH St
Des Moines, IA 50316-1901
Phone
(515) 262-0404
Fax
(515) 262-0489
NPI assigned
Jul 29, 2007
Last updated
Jan 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R8458 IA
Family Medicine Physician 207Q00000X 4031 IA Primary

Addresses

Primary practice location

2301 E 14TH St
Des Moines, IA 50316-1901

Mailing address

2301 E 14TH St
Des Moines, IA 50316-1901
Phone (515) 262-0404

Other identifiers 1

IdentifierTypeStateIssuer
1083804793MedicaidIA

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
I20100120000755 IA Practitioner - Family Practice 9032204276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 E 14TH St
Family Med Parks
Des Moines, IA 50316-1901
Phone (515) 262-0404

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

801 Colonial Cir
Norwalk, IA 50211-9626
Phone (515) 285-3200

840 E University Ave
FM East Des Moines
Des Moines, IA 50316-2304
Phone (515) 265-4211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4031IAMDFamily Medicine Physician
R8458IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
Unitypoint at Home PastSince Jan 1, 2021 Accepting new patients

Locations

410 NW Ash Dr
Ankeny, IA 50023
Phone (515) 964-1101

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

2301 E 14th St
Des Moines, IA 50316
Phone (515) 262-0404

801 Colonial Cir
Norwalk, IA 50211
Phone (515) 285-3200

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

555 S 51st St
West Des Moines, IA 50265
Phone (515) 221-2751

Interoperability endpoints

  • Direct secure messaging: hbermel12694@direct.unitypoint.org

Organizations & group practices 3

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 4

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": "1185667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1083804793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503161901",
            "telephone_number": "515-262-0404",
            "fax_number": "515-262-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503161901",
            "telephone_number": "515-262-0404",
            "fax_number": "515-262-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMEL",
        "first_name": "HOLLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-29",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R8458",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "4031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083804793",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.