NPIMap

Organization Active NPI

Heartland Vascular Medicine and Surgery PC

  • Vascular Surgery Physician
  • Windsor Heights, IA
National Provider Identifier
1184787343
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
30390 Issued in IA
Legal business name
HEARTLAND VASCULAR MEDICINE AND SURGERY PC
Practice address
974 73Rd St
Suite 23
Windsor Heights, IA 50324-1024
Phone
(515) 284-1976
Fax
(515) 223-3010
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
Dr. Alan Russell Koslow, M.D, F.A.C.SNPI 1427004464
Title
Owner
Phone
(515) 284-1976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 30390 IA Primary

Addresses

Primary practice location

974 73Rd St
Suite 23
Windsor Heights, IA 50324-1024

Mailing address

974 73Rd St
Suite 23
Windsor Heights, IA 50324-1024
Phone (515) 284-1976

Other identifiers 2

IdentifierTypeStateIssuer
2119164MedicaidIA
38295OtherIAWELLMARK

National Provider Directory

National Provider Directory

Locations

974 73rd St
Ste 23
West Des Moines, IA 50265
Phone (515) 284-1976

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1184787343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 73RD ST",
            "address_2": "SUITE 23",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503241024",
            "telephone_number": "515-284-1976",
            "fax_number": "515-223-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 73RD ST",
            "address_2": "SUITE 23",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503241024",
            "telephone_number": "515-284-1976",
            "fax_number": "515-223-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND VASCULAR MEDICINE AND SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "KOSLOW",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-284-1976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D, F.A.C.S"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IA",
            "license": "30390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2119164",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "38295",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Heights, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.