NPIMap

Organization Active NPI

Mahaska County Hospital

Doing business as Mahaska Health

  • Critical Access Hospital
  • Oskaloosa, IA
National Provider Identifier
1356320659
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
620092H Issued in IA
Legal business name
MAHASKA COUNTY HOSPITAL
Doing business as
Mahaska Health
Practice address
1229 C Ave E
Oskaloosa, IA 52577-4298
Phone
(641) 672-3100
Fax
(641) 672-3111
NPI assigned
Jan 13, 2006
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Kevin Deronde
Title
Ceo
Phone
(641) 672-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 620092H IA Primary

Addresses

Primary practice location

1229 C Ave E
Oskaloosa, IA 52577-4298

Mailing address

1229 C Ave E
Oskaloosa, IA 52577-4298
Phone (641) 672-3100

Other identifiers 1

IdentifierTypeStateIssuer
0600502MedicaidIA

Other names 1

  • MAHASKA HEALTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000235 IA Part A Provider - Critical Access Hospital 2769388677 Receives reassigned benefits from 116 practitioners
Practice locations: Oskaloosa, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356320659. Details of each certification follow.

Hospital certification: CCN 161379

Legal name
MAHASKA COUNTY HOSPITAL
Doing business as
MAHASKA HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2005
Last certification
Dec 10, 2015
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1229 C Ave E
Oskaloosa, IA 52577-4298
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Mahaska Health PartnershipCCN 161379 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
New Sharon Medical Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marsha K Riordan Individual Corporate Officer Nov 17, 2021
Corporate Director Nov 28, 2018
Eric W Miller Individual W-2 Managing EmployeeChief of Staff May 1, 2023
Operational/Managerial ControlChief of Staff May 1, 2023
Gregory a Gordy Individual Corporate Officer Sep 22, 2021
Corporate Director Sep 22, 2021
Donna M Arendt Individual Corporate Officer Oct 27, 2021
Corporate Director Oct 27, 2021
David M Langkamp Individual Corporate Officer Jan 28, 2013
Corporate Director Nov 28, 2011
Andra King Individual W-2 Managing EmployeeCompliance Director Dec 28, 2020
Operational/Managerial ControlCompliance Director Dec 28, 2020
Guy M Vander Linden Individual Corporate Director Oct 27, 2021
Daris Rosencrance Individual Corporate OfficerCfo Nov 1, 2021
W-2 Managing EmployeeCfo Nov 1, 2021
Operational/Managerial ControlCfo Nov 1, 2021
Joette S Stout Individual Corporate Director Oct 27, 2021
Dustin D Hite Individual Corporate Director Apr 26, 2023
Kevin L Deronde Individual Corporate OfficerCeo Feb 19, 2018
W-2 Managing EmployeeCeo Feb 19, 2018
Operational/Managerial ControlCeo Feb 19, 2018
Andrea K Hagist Individual W-2 Managing EmployeeChief Nursing Officer Jul 20, 2018
Operational/Managerial ControlChief Nursing Officer Jul 20, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oskaloosa Care CenterOskaloosa, IA, CCN 165589 Skilled nursing facility Adp of the SNF May 19, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 116

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.

View all 116

Affiliated clinicians 147

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 147

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1356320659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 C AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525774298",
            "telephone_number": "641-672-3100",
            "fax_number": "641-672-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 C AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525774298",
            "telephone_number": "641-672-3100",
            "fax_number": "641-672-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHASKA COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "DERONDE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-672-3100"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "620092H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600502",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAHASKA HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oskaloosa, IA

Sources for this page

Verify at the official NPI Registry.