Individual provider Active NPI

Dylan Takeo Crebs, MD

  • Internal Medicine Physician
  • Des Moines, IA
National Provider Identifier
1356791404
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R10618 Issued in IA
Practice address
1415 Woodland Ave
Suite 140
Des Moines, IA 50309-3203
Phone
(515) 241-8595
Fax
(515) 241-4080
NPI assigned
Jun 20, 2016
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R10618 IA Primary

Addresses

Primary practice location

1415 Woodland Ave
Suite 140
Des Moines, IA 50309-3203

Mailing address

1415 Woodland Ave
Suite 140
Des Moines, IA 50309-3203
Phone (515) 241-8595

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210707003081 CA Practitioner - Diagnostic Radiology 4082908710 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

9455 Clairemont Mesa Blvd
San Diego, CA 92123-1297
Phone (858) 573-1504

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Internal Medicine CurrentSince Jun 28, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 28, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2022 Accepting new patients
UCSF Medical Group Business Services Internal Medicine CurrentSince Jun 28, 2021 Accepting new patients
University of California San Francisco CurrentSince Jun 28, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
University of California San Francisco Current Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Organizations & group practices 8

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 2

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1356791404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WOODLAND AVE",
            "address_2": "SUITE 140",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093203",
            "telephone_number": "515-241-8595",
            "fax_number": "515-241-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WOODLAND AVE",
            "address_2": "SUITE 140",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093203",
            "telephone_number": "515-241-8595",
            "fax_number": "515-241-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREBS",
        "first_name": "DYLAN",
        "middle_name": "TAKEO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R10618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "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.