NPIMap

Organization Active NPI

Physician Anesthesia Care of Iowa City PC

  • Anesthesiology Physician
  • Iowa City, IA
National Provider Identifier
1336112333
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHYSICIAN ANESTHESIA CARE OF IOWA CITY PC
Practice address
500 E Market St
Iowa City, IA 52245-2689
Phone
(319) 354-2653
Fax
(319) 339-1364
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Mrs. Kyuchal Patricia Chang, MD
Title
President
Phone
(319) 358-2768

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

500 E Market St
Iowa City, IA 52245-2689

Mailing address

540 E Jefferson St
Ste 106
Iowa City, IA 52245-2479
Phone (319) 354-2653

Other identifiers 1

IdentifierTypeStateIssuer
0152934MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001207 IA Part B Supplier - Clinic/Group Practice 7911899695 Receives reassigned benefits from 16 practitioners
Practice locations: Iowa City, IA; North Liberty, IA

National Provider Directory

National Provider Directory

Locations

540 E Jefferson St
Ste 106
Iowa City, IA 52245

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1336112333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 E JEFFERSON ST",
            "address_2": "STE 106",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452479",
            "telephone_number": "319-354-2653",
            "fax_number": "319-339-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MARKET ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452689",
            "telephone_number": "319-354-2653",
            "fax_number": "319-339-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ANESTHESIA CARE OF IOWA CITY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "KYUCHAL",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-358-2768",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152934",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.