Individual provider Active NPI

Jaime Rae Smolik, PA-C

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1295722791
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001440 Issued in IA
Practice address
1111 - 6TH Ave - East Tower
Suite B1
Des Moines, IA 50314-2613
Phone
(515) 358-0100
Fax
(515) 358-0109
NPI assigned
Sep 30, 2005
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001440 IA Primary

Addresses

Primary practice location

1111 - 6TH Ave - East Tower
Suite B1
Des Moines, IA 50314-2613

Mailing address

PO Box 4925
Des Moines, IA 50305-4925
Phone (515) 358-0100

Other practice location 1

1410 SW Tradition Dr Ste 110
Ankeny, IA 50023-9188
Phone (515) 875-9696

Other practice location 2

3815 Stange Rd
Ames, IA 50010-3914
Phone (515) 956-4044

Other practice location 3

2591 Holiday Rd
Coralville, IA 52241-3039
Phone (319) 356-3335

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsmolik101640@directmcfarlandclinic.com Health Information Exchange (HIE)

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
I20100116000397 IA Practitioner - Physician Assistant 6901948744 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Institute PCGroup PAC ID 8325030901, 3 clinicians

Practice addresses (Care Compare)

2001 Westown Pkwy
Suite 107
West Des Moines, IA 50265-1540
Phone (515) 223-8622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001440IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Aug 14, 2023 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Aug 14, 2023 Accepting new patients
Boone County Hospital Past Accepting new patients
Core Physical Therapy Inc PastSince Jul 11, 2012 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

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

1111 6th Ave
Ste B1
Des Moines, IA 50314
Phone (515) 358-0100

800 S Fillmore St
Osceola, IA 50213
Phone (641) 342-2184

800 S Fillmore St
Rm D120
Osceola, IA 50213
Phone (641) 342-5000

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1295722791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4925",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503054925",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 - 6TH AVE - EAST TOWER",
            "address_2": "SUITE B1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142613",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 SW Tradition Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500239188",
            "country_code": "US",
            "telephone_number": "515-875-9696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3815 Stange Rd",
            "address_purpose": "LOCATION",
            "city": "Ames",
            "state": "IA",
            "postal_code": "500103914",
            "country_code": "US",
            "telephone_number": "515-956-4044",
            "fax_number": "515-956-4075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2591 Holiday Rd",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522413039",
            "country_code": "US",
            "telephone_number": "319-356-3335",
            "fax_number": "319-467-7181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOLIK",
        "first_name": "JAIME",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmolik101640@directmcfarlandclinic.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3815 Stange Rd",
            "city": "Ames",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500103914",
            "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.