Samantha Marie Banser Bissen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO-05233 Issued in IA

Practice address

101 E J Ave Ste 120
Grundy Center, IA 50638-2004

Phone

(319) 824-6945

NPI assigned

Jun 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Marie Banser Former name

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

Specialty

Family Practice

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint at Home Home health agency, Waterloo, IA, CCN 167147
• Cedar Valley Hospice Hospice, Waterloo, IA, CCN 161504
• Grundy County Memorial Hospital Hospital, Grundy Center, IA, CCN 161303
• Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001
• Allen Hospital Hospital, Waterloo, IA, CCN 160110

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbanser429919@direct.unitypoint.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Grundy Center, IA
  • NPI 1255977740

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Unitypoint Health - Marshalltown

  • Emergency Medicine Physician
  • Marshalltown, IA
  • NPI 1164957593
  Medicare reassignment NPD
• Salahuddin Syed MD PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Marshalltown, IA
  • NPI 1083054464
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Waverly, IA
  • NPI 1124655006
  NPD
• Central Iowa Healthcare

  • Home Health Agency
  • Marshalltown, IA
  • NPI 1336125921
  NPD (past)

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

• Allen Memorial Hospital Corporation

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1336231091
  Care Compare affiliation
• Cedar Valley Hospice, Inc.

  • Community Based Hospice Care Agency
  • Waterloo, IA
  • NPI 1730304619
  Care Compare affiliation
• Grundy County Memorial Hospital

  • Critical Access Hospital
  • Grundy Center, IA
  • NPI 1821055989
  Care Compare affiliation
• Unitypoint at Home

  • Home Health Agency
  • Waterloo, IA
  • NPI 1154623460
  Care Compare affiliation
• Unitypoint Health - Marshalltown

  • General Acute Care Hospital
  • Marshalltown, IA
  • NPI 1629503057
  Care Compare affiliation

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1245769249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E J AVE STE 120",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E J AVE STE 120",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382004",
            "telephone_number": "319-824-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSEN",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE BANSER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BANSER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allen Memorial Hospital Corporation
• Arlington Place of Grundy Center
• Arlington Place of Grundy Center II, Inc.
• Lisa Bienfang
• Boerm Family Chiropractic PLLC
• Mitchell Lonnie Boerm, DC
• Trisha Ann Boos, PTA
• Wendy Brewer
• Lora Brunkhorst, COTA

• Family Medicine Physician in Grundy Center, IA
• Providers in Grundy Center, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.