Individual provider Active NPI

Anna Elizabeth Statz, D.O.

  • Psychiatry Physician
  • Ames, IA
National Provider Identifier
1235662982
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DO-05433 Issued in IA
Practice address
1111 Duff Ave.
Ames, IA 50010-5745
Phone
(515) 239-2011
NPI assigned
Apr 10, 2017
Reactivated
Aug 17, 2021
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Psychiatry Physician 2084P0800X DO-05433 IA Primary

Addresses

Primary practice location

1111 Duff Ave.
Ames, IA 50010-5745

Mailing address

1111 Duff Ave.
Ames, IA 50010-5745
Phone (515) 239-2011

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127000473 IA Practitioner - Osteopathic Manipulative Medicine 6608146451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Greeley Medical CenterGroup PAC ID 6507769247, 30 clinicians

Practice addresses (Care Compare)

1111 Duff Ave
Ames, IA 50010-5745
Phone (515) 239-2102

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-05433IAMDPsychiatry Physician
360SDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Greeley Medical Center CurrentSince Oct 15, 2019 Accepting new patients
Mary Greeley Medical Center Current Accepting new patients
Mary Greeley Medical Center Current Accepting new patients
Mary Greeley Medical Center CurrentSince Oct 15, 2019 Accepting new patients

Locations

1111 Duff Ave
Ames, IA 50010
Phone (515) 239-2011

1111 Duff Ave
Ste 1431
Ames, IA 50010
Phone (515) 239-2011

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1235662982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DUFF AVE.",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105745",
            "telephone_number": "515-239-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DUFF AVE.",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105745",
            "telephone_number": "515-239-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATZ",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-23",
        "deactivation_date": "2021-08-02",
        "reactivation_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "DO-05433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.