Mercy Clinics, Inc.
Organization Active NPI Primary Care Clinic/Center · Des Moines, IA
NPI 1194745752 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1194745752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- MERCY CLINICS, INC.
- Practice address
- 1350 Des Moines St Ste 110
Des Moines, IA 50309-5507 - Phone
- (515) 643-0833
- Fax
- (515) 643-0933
- NPI assigned
- Jul 19, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- MERCY CLINICS, INC.
Authorized official
- Name
- Bradley Whipple
- Title
- Coo
- Phone
- (515) 358-6956
Practitioners 19
-
Ricardo Andreotti Bodra, PA-C
-
Michael Blaess, DO
-
Laura Susan Eslinger, ARNP
-
Arber Frakulli, M.D.
-
Robert Hatchitt, DO
-
Joan Marie Julseth-Lewis, ARNP
-
Valerie Ann Knedler, ARNP
-
Stacey L Milani, MD
-
Amy Beth Mitchell, D.O.
-
Emily Myers, PA-C
-
Theresa Nguyen, MD
-
Amy Diane Oliver, ARNP
-
Dallas R Sanders, PA-C
-
Phyo Su Yin, MD
-
Andrew Zeff, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0676807 | Mercyone East Village Clinics | Certificate of waiver | Feb 28, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000238 | IA | Part B Supplier - Clinic/Group Practice | 7911810882 |
Receives reassigned benefits from 558 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Mercy Neurological Clin
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Pediatric Adolescent Medicine Physician |
2080A0000X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
1350 Des Moines St Ste 110
Des Moines, IA 50309-5507
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-0833
Other practice location 1
1350 Des Moines St Ste 110
Des Moines, IA 50309-5507
Phone (515) 358-6500
Other practice location 2
1350 Des Moines St Ste 100
Des Moines, IA 50309-5507
Phone (515) 643-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CD3776 | Other | IA | RAILROAD MEDICARE |
| 0450163 | Medicaid | IA |
Other names
- MercyOne East Village Family Medicine Clinic
- MercyOne East Village Internal Medicine
Other providers in Des Moines, IA
- Mercy Clinics, Inc
- Mercy Clinics, Inc
- Mercy Clinics, Inc
- Mercy Clinics, Inc.
- Mercy Clinics, Inc.
- Mercy Clinics, Inc.
- Mercy Clinics, Inc.
- Mercy Clinics, Inc.
- Mercy Clinics, Inc.
- Mercy Clinics, Inc.
All providers in Des Moines, IA · Primary Care Clinic/Center in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.