NPIMap

Individual provider Active NPI

Marta Tejedor Bravo, PHD, MBBS

  • Gastroenterology Physician
  • Iowa City, IA
National Provider Identifier
1134965882
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
SP-0284 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 467-8100
Fax
(319) 384-8559
NPI assigned
Jul 2, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X SP-0284 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 467-8100

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
I20240724002954 IA Practitioner - Gastroenterology 8224574454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Upper gastrointestinal (GI) endoscopy for acid reflux14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jul 1, 2024 Accepting new patients
Floyd County Memorial Hospital Commission Past 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
Iowa City, IA 52242
Phone (319) 356-1616

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1134965882",
    "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": "319-467-8100",
            "fax_number": "319-384-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-467-8100",
            "fax_number": "319-384-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJEDOR BRAVO",
        "first_name": "MARTA",
        "credential": "PHD, MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "SP-0284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.