Individual provider Active NPI

Mederic Micah Hall, M.D.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Iowa City, IA
National Provider Identifier
1093836728
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
MD-38299 Issued in IA
Practice address
2701 Prairie Meadow Dr
Iowa City, IA 52242-8001
Phone
(319) 467-8059
Fax
(319) 384-9305
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 49735 MN
Physical Medicine & Rehabilitation Physician 208100000X MD-38299 IA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X MD-38299 IA Primary

Addresses

Primary practice location

2701 Prairie Meadow Dr
Iowa City, IA 52242-8001

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 467-8059

Other practice location 1

105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000

Other practice location 2

701 W Forevergreen Rd
North Liberty, IA 52317-9848
Phone (319) 356-2223

Other identifiers 1

IdentifierTypeStateIssuer
718425000MedicaidMN

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
I20110620000094 IA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 6901999648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Rehabilitation Associates LLCGroup PAC ID 2961443072, 275 clinicians
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

1130 S Scott Blvd
Iowa City, IA 52240-2909
Phone (319) 354-2429

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

701 W Forevergreen Rd
Univ of Ia Health Care Med Ctr N Liberty
North Liberty, IA 52317-9848
Phone (319) 485-0550

Hospital & facility affiliations

  • University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49735MNMDPhysical Medicine & Rehabilitation Physician
MD-38299IAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jul 1, 2011 Accepting new patients
State University of Iowa Past Accepting new patients

Locations

105 E 9th St
Iowa City, IA 52241
Phone (319) 467-2000

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

701 W Forevergreen Rd
North Liberty, IA 52317
Phone (319) 356-2223

Interoperability endpoints

  • Direct secure messaging: mhall58349@uihcdirect.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1093836728",
    "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": "319-467-8059",
            "fax_number": "319-384-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PRAIRIE MEADOW DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522428001",
            "telephone_number": "319-467-8059",
            "fax_number": "319-384-9305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412209",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 W Forevergreen Rd",
            "address_purpose": "LOCATION",
            "city": "North Liberty",
            "state": "IA",
            "postal_code": "523179848",
            "country_code": "US",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "MEDERIC",
        "middle_name": "MICAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "49735",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IA",
            "license": "MD-38299",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "IA",
            "license": "MD-38299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718425000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.