Individual provider Active NPI

Matthew Herrmann, MD

  • Family Medicine Physician
  • West Des Moines, IA
National Provider Identifier
1093974172
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38714 Issued in IA
Practice address
6010 Mills Civic Pkwy
Ste 200
West Des Moines, IA 50266-8345
Phone
(515) 224-9666
Fax
(515) 224-5913
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-8768 IA
Surgery Physician 208600000X 94-06938 KS
Family Medicine Physician 207Q00000X 38714 IA Primary

Addresses

Primary practice location

6010 Mills Civic Pkwy
Ste 200
West Des Moines, IA 50266-8345

Mailing address

6010 Mills Civic Pkwy
Ste 200
West Des Moines, IA 50266-8345
Phone (515) 224-9666

Other identifiers 1

IdentifierTypeStateIssuer
1093974172MedicaidIA

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
I20100312000140 IA Practitioner - Family Practice 1658406913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

6010 Mills Civic Pkwy
West Des Moines, IA 50266-8345
Phone (515) 221-7800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38714IAMDFamily Medicine Physician
R-8768IAMDFamily Medicine Physician
94-06938KSMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
St Luke'S Methodist Hospital Current 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

6010 Mills Civic Pkwy
Ste 200
West Des Moines, IA 50266
Phone (515) 224-9666

Interoperability endpoints

  • Direct secure messaging: mherrmann44485@direct.unitypoint.org

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 and National Provider Directory roles.

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1093974172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 MILLS CIVIC PKWY",
            "address_2": "STE 200",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668345",
            "telephone_number": "515-224-9666",
            "fax_number": "515-224-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 MILLS CIVIC PKWY",
            "address_2": "STE 200",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668345",
            "telephone_number": "515-224-9666",
            "fax_number": "515-224-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-8768",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "94-06938",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "38714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093974172",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.