Individual provider Active NPI

Timothy C Ryken, MD

  • Neurological Surgery Physician
  • Des Moines, IA
National Provider Identifier
1235122359
Registry record updated Mar 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
18138 Issued in NH
Practice address
1215 Pleasant St Ste 608
Des Moines, IA 50309-1418
Phone
(515) 241-5760
Fax
(515) 241-8161
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD-28456 IA
Neurological Surgery Physician 207T00000X 18138 NH Primary

Addresses

Primary practice location

1215 Pleasant St Ste 608
Des Moines, IA 50309-1418

Mailing address

630 E Amherst Ave
Englewood, CO 80113-1654
Phone (319) 331-6603

Other identifiers 2

IdentifierTypeStateIssuer
1030057MedicaidVT
3109341MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, CO2 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
I20090423000114 IA Practitioner - Neurosurgery 9133277544 Reassigns benefits to 1 organization
I20230313002495 CO Practitioner - Neurosurgery 9133277544 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC CurrentSince Jan 25, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 11, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 11, 2023 Accepting new patients
The Iowa Clinic PC Neurological Surgery CurrentSince Jan 25, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC Neurological Surgery Current Accepting new patients
The New London Hospital Association, Inc. Past Accepting new patients

Locations

1215 Pleasant St
Ste 608
Des Moines, IA 50309
Phone (515) 241-5760

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

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

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

Interoperability endpoints

  • Direct secure messaging: tryken288373@direct.dartmouth-hitchcock.org

Organizations & group practices 6

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679184000000",
    "number": "1235122359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E AMHERST AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801131654",
            "telephone_number": "319-331-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 PLEASANT ST STE 608",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091418",
            "telephone_number": "515-241-5760",
            "fax_number": "515-241-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYKEN",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-03-19",
        "certification_date": "2023-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IA",
            "license": "MD-28456",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NH",
            "license": "18138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030057",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3109341",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.