NPIMap

Individual provider Active NPI

Michael D Obrien, MD

  • Gastroenterology Physician
  • Clive, IA
National Provider Identifier
1295793420
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
30471 Issued in IA
Practice address
1378 NW 124TH St
Suite 200
Clive, IA 50325-8151
Phone
(515) 288-6097
Fax
(515) 288-6099
NPI assigned
May 4, 2006
Last updated
May 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 30471 IA Primary

Addresses

Primary practice location

1378 NW 124TH St
Suite 200
Clive, IA 50325-8151

Mailing address

1378 NW 124TH St
Suite 200
Clive, IA 50325-8151
Phone (515) 288-6097

Other identifiers 1

IdentifierTypeStateIssuer
0122135MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060417000136 IA Practitioner - GastroenterologyPractitioner - Internal Medicine 3072411073 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Tulane University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Digestive Disease Center PCGroup PAC ID 4183522188, 24 clinicians

Practice addresses (Care Compare)

1378 NW 124TH St
Clive, IA 50325-8151

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 263-5770

3625 N Ankeny Blvd
Suite D
Ankeny, IA 50023-4611
Phone (515) 288-6097

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy216
Upper gastrointestinal (GI) endoscopy for acid reflux193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30471IAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Greene County Medical Center Gastroenterology CurrentSince May 31, 2016 Accepting new patients
Iowa Endoscopy Center, Inc. CurrentSince Jan 1, 1998 Accepting new patients
Greene County Medical Center Current Accepting new patients
Greene County Medical Center CurrentSince May 31, 2016 Accepting new patients
Iowa Digestive Disease Center P.C. Gastroenterology CurrentSince Jul 1, 1995 Accepting new patients
Greene County Medical Center CurrentSince Jan 1, 2026 Accepting new patients

Locations

3625 N Ankeny Blvd
Ste D
Ankeny, IA 50023
Phone (515) 288-6097

1378 NW 124th St
Ste 200
Clive, IA 50325
Phone (515) 288-6097

1378 NW 124th St
Ste 100
Clive, IA 50325
Phone (515) 226-8180

1000 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-2114

Interoperability endpoints

  • Direct secure messaging: mobrien12554@direct.unitypoint.org

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1295793420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097",
            "fax_number": "515-288-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097",
            "fax_number": "515-288-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "30471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122135",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.