Individual provider Active NPI

Susan Rhyan, PA-C

  • Physician Assistant
  • West Des Moines, IA
National Provider Identifier
1164419792
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1052 Issued in IA
Practice address
5950 University Ave Ste 136
West Des Moines, IA 50266
Phone
(515) 875-9766
Fax
(515) 875-9765
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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 1052 IA Primary

Addresses

Primary practice location

5950 University Ave Ste 136
West Des Moines, IA 50266

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susanrhyan@tic.allscriptsdirect.net

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
I20040302000505 IA Practitioner - Physician Assistant 2961399274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
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

5950 University Ave
West Des Moines, IA 50266-8232
Phone (515) 875-9100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1052IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC CurrentSince Aug 1, 2017 Accepting new patients
The Iowa Clinic, PC CurrentSince Aug 1, 2017 Accepting new patients

Locations

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

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

5950 University Ave
Ste 136
West Des Moines, IA 50266
Phone (515) 875-9766

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Interoperability endpoints

  • Direct secure messaging: susanrhyan@tic.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1164419792",
    "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",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 UNIVERSITY AVE STE 136",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-875-9766",
            "fax_number": "515-875-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHYAN",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "1052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susanrhyan@tic.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "5950 University Ave Ste 136",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50266",
            "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.