Individual provider Active NPI

Kelly Schifsky, D.O.

  • Developmental - Behavioral Pediatrics Physician
  • West Des Moines, IA
National Provider Identifier
1215375308
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
DO-04829 Issued in IA
Practice address
4055 Westown Pkwy
West Des Moines, IA 50266-1033
Phone
(515) 224-3399
NPI assigned
Jun 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R-9754 IA
Developmental - Behavioral Pediatrics Physician 2080P0006X 14830 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X DO-04829 IA Primary

Addresses

Primary practice location

4055 Westown Pkwy
West Des Moines, IA 50266-1033

Mailing address

4055 Westown Pkwy
West Des Moines, IA 50266-1033
Phone (515) 224-3399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191003002435 CA Practitioner - Pediatric Medicine 4587899869 Reassigns benefits to 1 organization
I20230504001111 IA Practitioner - Pediatric Medicine 4587899869 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-04829IAMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Feb 3, 2023 Accepting new patients
Central Iowa Hospital Corporation Current Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Sep 1, 2019 Accepting new patients
Central Iowa Hospital Corporation Pediatrics CurrentSince Feb 3, 2023 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

4055 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 224-3399

Interoperability endpoints

  • Direct secure messaging: kschifsky34495@direct.unitypoint.org

Organizations & group practices 5

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": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1215375308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661033",
            "telephone_number": "515-224-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661033",
            "telephone_number": "515-224-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIFSKY",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R-9754",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "14830",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "IA",
            "license": "DO-04829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.