Mayumi Oakland, PA-C

Individual provider Active NPI Physician Assistant · Iowa City, IA

NPI 1255830006 · NPPES record last updated Mar 12, 2019

Key facts

NPI
1255830006
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
090435 (IA)
Practice address
4189 Westlawn S
Iowa City, IA 52242
Phone
(319) 335-8390
Fax
(319) 335-7247
NPI assigned
Feb 7, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180315001208 IA Practitioner - Physician Assistant 7113289976 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
090435IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa Current
since Mar 6, 2019
Accepting new patients

Locations

920 E 2nd Ave
Ste 201B
Coralville, IA 52241
Phone (319) 467-2000

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

4189 Westlawn S
Iowa City, IA 52242
Phone (319) 335-8370

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

Interoperability endpoints

  • Direct secure messaging: moakland64951@uihcdirect.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 090435 IA Yes

Addresses

Primary practice location

4189 Westlawn S
Iowa City, IA 52242

Mailing address

4189 Westlawn S
Iowa City, IA 52242-1100
Phone (319) 335-8390

Other practice location 1

920 E 2nd Ave Ste 201B
Coralville, IA 52241-2225
Phone (319) 367-2000

Other practice location 2

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 384-7222

Other names

  • Mayumi Fukuda Former name

Other providers in Iowa City, IA

All providers in Iowa City, IA · Physician Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.