NPIMap

Individual provider Active NPI

Danielle Elaine Petersen

  • Physician Assistant
  • West Des Moines, IA
National Provider Identifier
1134819535
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
130557 Issued in IA
Practice address
5950 University Ave Ste 380
West Des Moines, IA 50266-8289
Phone
(515) 875-9908
Fax
(515) 875-9882
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 130557 IA Primary

Addresses

Primary practice location

5950 University Ave Ste 380
West Des Moines, IA 50266-8289

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniellepetersen@tic.allscriptsdirect.net

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
I20250424000155 IA Practitioner - Physician Assistant 0244756179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1005 Pennsylvania Ave
Suite 102a
Ottumwa, IA 52501-6408
Phone (641) 684-2589

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1000

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 358-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC CurrentSince May 5, 2025 Accepting new patients
The Iowa Clinic PC CurrentSince May 5, 2025 Accepting new patients

Locations

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

5950 University Ave
Ste 380
West Des Moines, IA 50266
Phone (515) 875-9902

Interoperability endpoints

  • Direct secure messaging: daniellepetersen@tic.allscriptsdirect.net
  • Direct secure messaging: dpetersen4107073@direct.trinity-health.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 7

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1134819535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 UNIVERSITY AVE STE 380",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668289",
            "telephone_number": "515-875-9908",
            "fax_number": "515-875-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DANIELLE",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "130557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniellepetersen@tic.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "5950 University Ave Ste 380",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502668289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.