NPIMap

Organization Active NPI

Medical Associates of Maquoketa, P.C.

  • Family Medicine Physician
  • Maquoketa, IA
National Provider Identifier
1295715597
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL ASSOCIATES OF MAQUOKETA, P.C.
Practice address
918 W Platt St # 1
Maquoketa, IA 52060-2038
Phone
(563) 652-5145
Fax
(563) 652-3674
NPI assigned
Jan 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Jennifer M Orr
Title
Office Administrator
Phone
(563) 652-5145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

918 W Platt St # 1
Maquoketa, IA 52060-2038

Mailing address

918 W Platt St # 1
Maquoketa, IA 52060-2038
Phone (563) 652-5145

Other identifiers 3

IdentifierTypeStateIssuer
0126896MedicaidIA
CP8149OtherIARAILROAD MEDICARE
1126896MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000336 IA Part B Supplier - Clinic/Group Practice 7416847181 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
Practice locations: Maquoketa, IA; Preston, IA; Wyoming, IA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Medical Associates of Maquoketa PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1295715597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 W PLATT ST # 1",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602038",
            "telephone_number": "563-652-5145",
            "fax_number": "563-652-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 W PLATT ST # 1",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602038",
            "telephone_number": "563-652-5145",
            "fax_number": "563-652-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF MAQUOKETA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "563-652-5145"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126896",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP8149",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1126896",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.