Individual provider Active NPI

Mark Smolik, MD

  • Surgery Physician
  • Des Moines, IA
National Provider Identifier
1124133087
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28916 Issued in IA
Practice address
411 Laurel St
Suite 2100
Des Moines, IA 50314-3017
Phone
(515) 247-3266
Fax
(515) 643-8688
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28916 IA Primary

Addresses

Primary practice location

411 Laurel St
Suite 2100
Des Moines, IA 50314-3017

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 247-3266

Other identifiers 1

IdentifierTypeStateIssuer
6120089MedicaidIA

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
I20100309000277 IA Practitioner - General Surgery 4284779778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Sanford School of Medicine of University of South Dakota, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

5901 Westown Pkwy
West Des Moines, IA 50266-8207
Phone (515) 358-9300

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28916IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 1, 1996 Accepting new patients
Mercy Clinics Inc Surgery CurrentSince Aug 1, 1996 Accepting new patients
Boone County Hospital Past Accepting new patients
Catholic Health Initiatives - Iowa Corp Past Accepting new patients

Locations

1200 N 7th St
Chariton, IA 50049
Phone (515) 774-3000

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

411 Laurel St
Ste 2100
Des Moines, IA 50314
Phone (515) 418-9960

5901 Westown Pkwy
Ste 230
West Des Moines, IA 50266
Phone (515) 344-2060

Interoperability endpoints

  • Direct secure messaging: msmolik3958197@direct.trinity-health.org

Organizations & group practices 5

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1124133087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-247-3266",
            "fax_number": "515-643-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST",
            "address_2": "SUITE 2100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143017",
            "telephone_number": "515-247-3266",
            "fax_number": "515-643-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLIK",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "28916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6120089",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.