NPIMap

Individual provider Active NPI

Rachelle Alexandra Makinde, MD

  • Anesthesiology Physician
  • Waterloo, IA
National Provider Identifier
1093159642
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD-44239 Issued in IA
Practice address
3421 W 9TH St
Waterloo, IA 50702-5401
Phone
(319) 272-5000
Fax
(319) 272-5264
NPI assigned
Apr 25, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10047737 TX
Anesthesiology Physician 207L00000X MD-44239 IA Primary

Addresses

Primary practice location

3421 W 9TH St
Waterloo, IA 50702-5401

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other practice location 1

5201 Harry Hines Blvd
Graduate Medical Education
Dallas, TX 75235-7708
Phone (214) 590-8058

Other names 1

  • Rachelle Alexandra Dorvil Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170822000129 IA Practitioner - Anesthesiology 5395017669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Southwestern Medical School at Dallas, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

3421 W 9TH St
Mercyone Waterloo Medical Center
Waterloo, IA 50702-5401
Phone (319) 272-7050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10047737TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center Inc CurrentSince Aug 14, 2017 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Aug 14, 2017 Accepting new patients

Locations

751 Main St
Arlington, IA 50606
Phone (563) 633-6965

226 Bluebell Rd
Cedar Falls, IA 50613
Phone (319) 575-5800

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

Interoperability endpoints

  • Direct secure messaging: rmakinde3934283@direct.trinity-health.org

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Mercyone Oelwein Medical CenterOelwein, IA, CCN 161338 Hospital Corporate Officer
Corporate Director		 Jan 1, 2022
Jan 1, 2022
Mercyone Oelwein Medical CenterOelwein, IA, CCN 16Z338 Hospital Corporate Officer
Corporate Director		 Jan 1, 2022
Jan 1, 2022
Mercyone Waterloo Medical CenterWaterloo, IA, CCN 16T067 Hospital Corporate Officer
Corporate Director		 Jan 1, 2025
Jan 1, 2022
Mercyone Cedar Falls Medical CenterCedar Falls, IA, CCN 160040 Hospital Corporate Officer
Corporate Director		 Jan 1, 2022
Jan 1, 2023
Mercyone Waterloo Medical CenterWaterloo, IA, CCN 160067 Hospital Corporate Officer
Corporate Director		 Jan 1, 2025
Jan 1, 2022
Mercyone Waterloo Home Health CareWaterloo, IA, CCN 167186 Home health agency Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 6

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

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 2

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093159642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-5264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Harry Hines Blvd",
            "address_2": "Graduate Medical Education",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357708",
            "country_code": "US",
            "telephone_number": "214-590-8058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKINDE",
        "first_name": "RACHELLE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10047737",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "MD-44239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "DORVIL",
            "middle_name": "ALEXANDRA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.