Kirsten Dickinson, MD
Individual provider Active NPI Dermatology Physician · Clive, IA
NPI 1366893752 · NPPES record last updated Jun 21, 2024
Key facts
- NPI
- 1366893752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 4301504690 (MI)
- Practice address
- 12327 Stratford Dr
Clive, IA 50325-8148 - Phone
- (515) 224-7088
- Fax
- (515) 224-9228
- NPI assigned
- Jun 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Forefront Dermatology SC
Practice addresses (Care Compare)
12327 Stratford Dr
Clive, IA 50325-8148
Phone (515) 224-7088
2601 Coolidge Rd
Suite 200
East Lansing, MI 48823-6381
Phone (517) 203-3000
Hospital & facility affiliations
- Mercyone Newton Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.45 of 100
- Promoting interoperability
- 97
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 239 |
| Removal of skin lesions | 498 |
| Removal of skin cancer | 725 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 289 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190730000250 | IA | Practitioner - Dermatology |
1153614334 | Reassigns benefits to 1 organization |
| I20210701002242 | MI | Practitioner - Dermatology |
1153614334 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R10695 | IA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forefront Dermatology, S.C. | Dermatology | Current | Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Current |
Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Current | Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Current |
Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Current |
Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Past | Accepting new patients |
Locations
500 Main St
Ste 113
Ames, IA 50010
Phone (515) 232-3006
2785 N Ankeny Blvd
Ste 24
Ankeny, IA 50023
Phone (515) 964-5503
855 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 366-2013
202 10th St SE
Ste 270
Cedar Rapids, IA 52403
Phone (319) 294-4319
12327 Stratford Dr
Des Moines, IA 50325
Phone (515) 224-7088
204 N 4th Ave E
Newton, IA 50208
Phone (641) 791-4800
305 E Eisenhower Pkwy
Ste 320
Ann Arbor, MI 48108
Phone (734) 800-2005
42452 Hayes Rd
Ste 3
Clinton Twp, MI 48038
Phone (586) 263-3130
2601 Coolidge Rd
Ste 200
East Lansing, MI 48823
Phone (517) 203-3000
4362 Cascade Rd SE
Ste 206
Grand Rapids, MI 49546
Phone (616) 678-2070
1007 Harbor Hills Dr
Ste C
Marquette, MI 49855
Phone (906) 225-5458
1602 Military St
Port Huron, MI 48060
Phone (810) 982-9527
801 York St
Manitowoc, WI 54220
Phone (866) 630-9882
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | 4301504690 | MI | |
| Dermatology Physician | 207N00000X | 35.139357 | OH | |
| Dermatology Physician | 207N00000X | R-10964 | IA | |
| Internal Medicine Physician | 207R00000X | R10695 | IA | |
| Dermatology Physician | 207N00000X | 4301504690 | MI | Yes |
Addresses
Primary practice location
12327 Stratford Dr
Clive, IA 50325-8148
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008
Other practice location 1
1602 Military St
Port Huron, MI 48060-5933
Phone (810) 982-9527
Other practice location 2
42452 Hayes Rd Ste 3
Clinton Township, MI 48038-6771
Phone (586) 263-3130
Other practice location 3
2785 N Ankeny Blvd Ste 24
Ankeny, IA 50023-4705
Phone (515) 964-5503
Other practice location 4
204 N 4th Ave E
Newton, IA 50208-3135
Phone (515) 224-7088
Other practice location 5
500 Main St Ste 113
Ames, IA 50010-6083
Phone (515) 232-3006
Other names
- Kirsten Goetz
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Kirsten.Dickinson@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Kirsten.Dickinson@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Kirsten.Dickinson@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Kirsten.Dickinson@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Kirsten.Dickinson@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Kirsten.Dickinson@forefrontdermatology.emadirect.md |
Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.