David Nystrom, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3647 Issued in IA

Practice address

405 S Clark St
Suite # 230
Carroll, IA 51401-3065

Phone

(712) 792-2222

Fax

(712) 792-3875

NPI assigned

Feb 15, 2006

Last updated

Oct 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Audubon County Memorial HospitalGroup PAC ID 7618866096, shared by 5 NPIs, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Anthony Regional Hospital & Nursing Home Hospital, Carroll, IA, CCN 161382
• Audubon County Memorial Hospital Hospital, Audubon, IA, CCN 161330

Merit-based Incentive Payment System (MIPS)

Final score

77.64 of 100Reported as group

Quality

69.74

Promoting interoperability

83

Improvement activities

40

Cost

69.88

Merit-based Incentive Payment System (MIPS)

Final score

95.27 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• St Anthony Regional Hospital and Nursing Home

  • Critical Access Hospital
  • Carroll, IA
  • NPI 1720067127
  Medicare reassignment NPD
• St Anthony Regional Hospital and Nursing Home

  • Family Medicine Physician
  • Carroll, IA
  • NPI 1801815972
  Medicare reassignment NPD
• St Anthony Regional Hospital and Nursing Home

  • Emergency Medicine Physician
  • Carroll, IA
  • NPI 1891711925
  NPD
• Summit BHC Iowa, LLC

  dba Ivory Plains Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Adair, IA
  • NPI 1922795541
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Audubon County Memorial Hospital

  • Critical Access Hospital
  • Audubon, IA
  • NPI 1710951686
  Care Compare affiliation
• St Anthony Regional Hospital and Nursing Home

  • Critical Access Hospital
  • Carroll, IA
  • NPI 1720067127
  Care Compare affiliation

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1356315311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S CLARK ST STE 100",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013047",
            "telephone_number": "712-792-2222",
            "fax_number": "712-792-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S CLARK ST",
            "address_2": "SUITE # 230",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013065",
            "telephone_number": "712-792-2222",
            "fax_number": "712-792-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0469395",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas J. Fangman DDS (Dr. Nicholas J. Fangman)
• Randi Nichols, HIS
• Shane Nissen
• Glenna R Nockels, LMSW
• Northland Hearing Centers, Inc. (Hearing Unlimited)
• Victor Ogoti
• Omaha Vamc
• Opco Carroll, Ia, LLC (Regency Park Nursing and Rehabilitation Center of Carroll)
• Pamela Marie Osterhaus, PHARM.D.
• Jamie W Ostrander, O.D.

• Family Medicine Physician in Carroll, IA
• Providers in Carroll, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.