Individual provider Active NPI

Rebecca Koresh, DO

  • Pediatrics Physician
  • Des Moines, IA
National Provider Identifier
1124510755
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R-11248 Issued in IA
Practice address
1200 Pleasant St
Des Moines, IA 50309-1453
Phone
(515) 241-5008
NPI assigned
May 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R-11248 IA Primary

Addresses

Primary practice location

1200 Pleasant St
Des Moines, IA 50309-1453

Mailing address

1200 Pleasant St
Des Moines, IA 50309-1453
Phone (515) 241-5008

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
I20210830000132 IA Practitioner - Pediatric Medicine 5991100927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-11248IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince Sep 13, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

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

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

2140 Logan Ave
Ste D
Waterloo, IA 50703
Phone (319) 226-8480

Interoperability endpoints

  • Direct secure messaging: rkoresh622654@direct.unitypoint.org

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1124510755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORESH",
        "first_name": "REBECCA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R-11248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.