Individual provider Active NPI

Randolph R Rough, M.D.

  • Cardiovascular Disease Physician
  • West Des Moines, IA
National Provider Identifier
1376525196
Registry record updated Jun 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
23764 Issued in IA
Practice address
5880 University Ave Ste 102
West Des Moines, IA 50266-8209
Phone
(515) 633-3600
Fax
(515) 288-0840
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 23764 IA Primary

Addresses

Primary practice location

5880 University Ave Ste 102
West Des Moines, IA 50266-8209

Mailing address

PO Box 9170
Des Moines, IA 50306-9170
Phone (515) 633-3600

Other identifiers 1

IdentifierTypeStateIssuer
0206607MedicaidIA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000718 IA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1850437849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives-Iowa CorpGroup PAC ID 5698683142, 111 clinicians

Practice addresses (Care Compare)

1 Saint Joseph Dr
Centerville, IA 52544-9017
Phone (641) 437-3411

1002 S Lincoln St
Knoxville, IA 50138-3121
Phone (641) 842-2151

1005 Pennsylvania Ave
Suite 207
Ottumwa, IA 52501-6414
Phone (641) 682-5349

1015 Union St
Boone, IA 50036-4821
Phone (515) 433-8481

1301 W Main St
Lake City, IA 51449-1585
Phone (712) 464-3171

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 358-8000

1816 Philadelphia St
Ames, IA 50010-8771
Phone (515) 232-2500

204 N 4TH Ave E
Newton, IA 50208-3135
Phone (641) 792-1273

300 W Hutchings St
Winterset, IA 50273-2109
Phone (515) 462-2950

405 S Clark St
Suite 205
Carroll, IA 51401-3047
Phone (712) 792-6500

411 Laurel St
Suite 1225
Des Moines, IA 50314-3017
Phone (515) 633-3770

411 Laurel St
Suite A250
Des Moines, IA 50314-3029
Phone (515) 235-5000

507 N Madison St
Bloomfield, IA 52537-1271
Phone (641) 664-2145

515 Pacific Ave
Audubon, IA 50025-1056
Phone (712) 563-2611

5880 University Ave
West Des Moines, IA 50266-8209
Phone (515) 633-3600

609 SE Kent St
Greenfield, IA 50849-9454
Phone (641) 743-2123

610 10TH St
Perry, IA 50220-2221
Phone (515) 465-3547

6580 165TH St
Albia, IA 52531-8793
Phone (641) 932-1756

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083
  • Van Diest Medical Center Hospital, Webster City, IA, CCN 161361
  • Mercyone Centerville Medical Center Hospital, Centerville, IA, CCN 161377
  • Mercyone Newton Medical Center Hospital, Newton, IA, CCN 160032
  • Knoxville Hospital & Clinics Hospital, Knoxville, IA, CCN 161355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23764IAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives-Iowa Corp CurrentSince Oct 1, 2009 Accepting new patients
Catholic Health Initiatives-Iowa Corp Cardiovascular Disease CurrentSince Oct 1, 2009 Accepting new patients
Iowa Heart Center PC Cardiovascular Disease Past Accepting new patients

Locations

1816 Philadelphia St
Ames, IA 50010
Phone (515) 232-2500

800 Mercy Dr
Ste 120
Council Bluffs, IA 51503
Phone (712) 388-2633

411 Laurel St
Ste A250
Des Moines, IA 50314
Phone (515) 235-5000

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

800 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6800

3 S 4th Ave
Marshalltown, IA 50158
Phone (641) 754-5145

5880 University Ave
Ste 102
West Des Moines, IA 50266
Phone (515) 633-3600

5880 University Ave
West Des Moines, IA 50266
Phone (515) 633-3600

Interoperability endpoints

  • Direct secure messaging: randolph.rough.p1@direct.iowaheart.nextgenshare.com
  • Direct secure messaging: rrough3956318@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592092800000",
    "number": "1376525196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9170",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503069170",
            "telephone_number": "515-633-3600",
            "fax_number": "515-633-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 UNIVERSITY AVE STE 102",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668209",
            "telephone_number": "515-633-3600",
            "fax_number": "515-288-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUGH",
        "first_name": "RANDOLPH",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "23764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206607",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.