Individual provider Active NPI

Timothy John Vandyke, M.D.

  • Trauma Surgery Physician
  • Des Moines, IA
National Provider Identifier
1295116192
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
MD-48679 Issued in IA
Practice address
1212 Pleasant St Ste 211
Des Moines, IA 50309-1411
Phone
(515) 875-9770
Fax
(515) 875-9771
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X MD-48679 IA Primary

Addresses

Primary practice location

1212 Pleasant St Ste 211
Des Moines, IA 50309-1411

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9925

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothyvandyke@tic.allscriptsdirect.net Direct

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
I20210713001388 IA Practitioner - General Surgery 9335457944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1005 Pennsylvania Ave
Suite 102a
Ottumwa, IA 52501-6408
Phone (641) 684-2589

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6212

1212 Pleasant St
Suite 211
Des Moines, IA 50309-1411
Phone (515) 875-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
The Iowa Clinic, PC CurrentSince Sep 7, 2021 Accepting new patients
The Iowa Clinic PC CurrentSince Sep 7, 2021 Accepting new patients
Central Iowa Hospital Corporation Past Accepting new patients

Locations

1212 Pleasant St
Ste 211
Des Moines, IA 50309
Phone (515) 875-9770

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: timothyvandyke@tic.allscriptsdirect.net
  • Direct secure messaging: tvandyke835984@direct.unitypoint.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1295116192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT ST STE 211",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091411",
            "telephone_number": "515-875-9770",
            "fax_number": "515-875-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2024-01-12",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IA",
            "license": "MD-48679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothyvandyke@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1212 Pleasant St Ste 211",
            "city": "Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "503091411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.