Individual provider Active NPI

Jeffrey Sisul, ARNP

  • Family Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1275950339
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A110968 Issued in IA
Practice address
411 Laurel St Ste 3250
Des Moines, IA 50314-3026
Phone
(515) 643-6400
Fax
(515) 643-5816
NPI assigned
Mar 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A110968 IA Primary

Addresses

Primary practice location

411 Laurel St Ste 3250
Des Moines, IA 50314-3026

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-6400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140512001447 IA Practitioner - Nurse Practitioner 7810120151 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 643-2084

Hospital & facility affiliations

  • Monroe County Hospital Hospital, Albia, IA, CCN 161342
  • Davis County Hospital Hospital, Bloomfield, IA, CCN 161327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A110968IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc CurrentSince Aug 1, 2017 Accepting new patients
Davis County Hospital CurrentSince Sep 28, 2022 Accepting new patients
Mercy Clinics, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Monroe County Hospital Current Accepting new patients
Davis County Hospital CurrentSince Sep 28, 2022 Accepting new patients
Monroe County Hospital Current Accepting new patients
Monroe County Hospital CurrentSince Oct 28, 2015 Accepting new patients
Mercy Clinics, Inc. Family Current Accepting new patients
Des Moines River Physicians, LLC Current Accepting new patients
Davis County Hospital Current Accepting new patients
Wayne County Hospital Current Accepting new patients
Des Moines River Physicians, LLC CurrentSince Jan 14, 2017 Accepting new patients

Locations

6580 165th St
Albia, IA 52531
Phone (641) 932-1756

509 N Madison St
Bloomfield, IA 52537
Phone (641) 664-2145

417 S East St
Corydon, IA 50060
Phone (641) 872-2260

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

411 Laurel St
Ste 3250
Des Moines, IA 50314
Phone (515) 643-6400

204 N 4th Ave E
Newton, IA 50208
Phone (641) 791-4800

300 N 4th Ave E
Ste C
Newton, IA 50208
Phone (641) 792-1273

Interoperability endpoints

  • Direct secure messaging: jsisul3957453@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1275950339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-6400",
            "fax_number": "515-643-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE 3250",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143026",
            "telephone_number": "515-643-6400",
            "fax_number": "515-643-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISUL",
        "first_name": "JEFFREY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A110968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.