Individual provider Active NPI

Rosalee M Mares Fernandez, PAC

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1144208471
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000990 Issued in IA
Practice address
4631 Merle Hay Rd
Des Moines, IA 50322-1962
Phone
(515) 278-0949
Fax
(515) 278-6721
NPI assigned
Jan 6, 2006
Last updated
Nov 2, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000990 IA Primary

Addresses

Primary practice location

4631 Merle Hay Rd
Des Moines, IA 50322-1962

Mailing address

4631 Merle Hay Rd
Des Moines, IA 50322-1962
Phone (515) 278-0949

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000823 IA Practitioner - Physician Assistant 2163566993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 SW Oralabor Rd
Upc Express Care
Ankeny, IA 50023-1280
Phone (515) 965-7661

1152 SE Ashworth Rd
Waukee, IA 50263-8843
Phone (515) 264-2200

180 Jordan Creek Pkwy
Suite 120
West Des Moines, IA 50266-8490
Phone (515) 224-5868

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

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

5200 100TH St
Urbandale, IA 50322-7208
Phone (515) 251-3880

6520 SE 14TH St
Des Moines, IA 50320-1846
Phone (515) 953-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Jul 1, 1997 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jul 1, 1997 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

4631 Merle Hay Rd
Des Moines, IA 50322
Phone (515) 278-0949

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

180 Jordan Creek Pkwy
Ste 120
West Des Moines, IA 50266
Phone (515) 224-5868

Interoperability endpoints

  • Direct secure messaging: rmaresfernandez37930@direct.unitypoint.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1144208471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 MERLE HAY RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503221962",
            "telephone_number": "515-278-0949",
            "fax_number": "515-278-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 MERLE HAY RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503221962",
            "telephone_number": "515-278-0949",
            "fax_number": "515-278-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARES FERNANDEZ",
        "first_name": "ROSALEE",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "000990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.