Kenneth M Andersen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24339 Issued in IA

Practice address

5615 NW 86TH St
Johnston, IA 50131-1738

Phone

(515) 643-6000

Fax

(515) 643-6001

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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.

• Mercy Clinics, Inc.

  • Primary Care Clinic/Center
  • Clive, IA
  • NPI 1487670923

  Family Medicine, IA

  Medicare reassignment Care Compare group NPD
• Mercy Clinics, Inc

  • Family Medicine Physician
  • Urbandale, IA
  • NPI 1063438638

  Family Medicine

  NPD
• Mercy Clinics, Inc

  • Primary Care Clinic/Center
  • Johnston, IA
  • NPI 1194741694
  NPD
• Mercy Clinics, Inc.

  • Obstetrics & Gynecology Physician
  • Des Moines, IA
  • NPI 1508741505
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives - Iowa Corp

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1538395975

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  • Clinical Medical Laboratory
  • Des Moines, IA
  • NPI 1104982743

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1508964883

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives, Ia-Corp

  • Mammography Clinic/Center
  • Des Moines, IA
  • NPI 1477984367

  Hospital

  Care Compare affiliation
• Trinity Home Health Services

  • Home Health Agency
  • Des Moines, IA
  • NPI 1982993317
  Care Compare affiliation

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinics Inc 441 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Des Moines Home Care Home health agency, Des Moines, IA, CCN 167133
• Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

Procedures performed for Medicare patients

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kandersen3938308@direct.trinity-health.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 21, 2024.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705795200000",
    "number": "1386654986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-6000",
            "fax_number": "515-643-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 NW 86TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311738",
            "telephone_number": "515-643-6000",
            "fax_number": "515-643-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-01-21",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "24339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020362",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sidney Ann Allen
• Alma Henry Clinical Services, PLLC
• Ames Creative Healing Counseling
• John Gregory Amspaugh, MD
• Amy Z Therapy Services
• Amber Lynn Anderson, DNP
• Julia Anderson, OTR/L
• Mariah K Anderson, RBT
• Molly Applegate, RBT
• Arc Ia LLC

• All providers in Johnston, IA
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.