Individual provider Active NPI

David E Kragenbrink, MD

  • Pediatrics Physician
  • Dubuque, IA
National Provider Identifier
1154316800
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30061 Issued in IA
Practice address
1500 Delhi St
Suite 3500
Dubuque, IA 52001-6321
Phone
(563) 557-5911
Fax
(563) 557-5910
NPI assigned
Sep 19, 2005
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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 30061 IA Primary

Addresses

Primary practice location

1500 Delhi St
Suite 3500
Dubuque, IA 52001-6321

Mailing address

1500 Delhi St
Suite 3500
Dubuque, IA 52001-6321
Phone (563) 557-5911

Other identifiers 2

IdentifierTypeStateIssuer
16783OtherIAWELLMARK BCBS
3116665MedicaidIA

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
I20250603001982 IA Practitioner - Pediatric Medicine 8527050236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30061IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince May 4, 2025 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

1500 Delhi St
Ste 3500
Dubuque, IA 52001
Phone (563) 557-3900

245 Railroad Ave
Ste F1
Dubuque, IA 52003
Phone (563) 557-3930

3500 Dodge St
Ste 135
Dubuque, IA 52003
Phone (563) 557-3935

Interoperability endpoints

  • Direct secure messaging: david.kragenbrink@grandrivermedicalgroup.eclinicaldirectplus.com
  • Direct secure messaging: dkragenbrink97927@direct.unitypoint.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, 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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1154316800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 DELHI ST",
            "address_2": "SUITE 3500",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016321",
            "telephone_number": "563-557-5911",
            "fax_number": "563-557-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DELHI ST",
            "address_2": "SUITE 3500",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016321",
            "telephone_number": "563-557-5911",
            "fax_number": "563-557-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAGENBRINK",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "30061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "16783",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3116665",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.