Individual provider Active NPI

Nicholas Van Beek

  • Physician Assistant
  • Pella, IA
National Provider Identifier
1366171480
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
122562 Issued in IA
Practice address
405 Monroe St
Pella, IA 50219-1189
Phone
(641) 621-2200
NPI assigned
Jun 6, 2022
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 122562 IA Primary

Addresses

Primary practice location

405 Monroe St
Pella, IA 50219-1189

Mailing address

717 Delaware Ave SW
Orange City, IA 51041-1961

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305001646 IA Practitioner - Physician Assistant 2163867797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pella Regional Health CenterGroup PAC ID 9931005873, shared by 10 NPIs, 96 clinicians

Practice addresses (Care Compare)

920 N Quincy Ave
Ottumwa Medical Clinic
Ottumwa, IA 52501-3866
Phone (641) 455-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pella Regional Health Center CurrentSince Feb 1, 2024 Accepting new patients
Pella Regional Health Center Current Accepting new patients

Locations

404 Jefferson St
Pella, IA 50219
Phone (641) 628-3150

405 Monroe St
Pella, IA 50219
Phone (641) 621-2200

Organizations & group practices 2

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 1

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": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1366171480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 DELAWARE AVE SW",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-621-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BEEK",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "122562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.