Individual provider Active NPI

Alexis Ahlberg, PA-C

  • Physician Assistant
  • Cedar Rapids, IA
National Provider Identifier
1396330288
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
105900 Issued in IA
Practice address
788 8TH Ave SE Ste 300
Cedar Rapids, IA 52401-2106
Phone
(319) 369-4542
NPI assigned
Mar 3, 2021
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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 105900 IA Primary

Addresses

Primary practice location

788 8TH Ave SE Ste 300
Cedar Rapids, IA 52401-2106

Mailing address

1017 Bowler St
Hiawatha, IA 52233-1919
Phone (515) 346-2669

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
I20210401002030 IA Practitioner - Physician Assistant 8921415266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

1765 Lininger LN
Suite 1
North Liberty, IA 52317-2336
Phone (319) 665-3053

600 7TH St SE
101 Care Connections Clinic at Mercy
Cedar Rapids, IA 52401-2125
Phone (319) 398-6860

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105900IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Mar 1, 2021 Accepting new patients
Mercy Medical Center CurrentSince Mar 1, 2021 Accepting new patients

Locations

600 7th St SE
Ste 200
Cedar Rapids, IA 52401
Phone (319) 369-4542

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

788 8th Ave SE
Ste 300
Cedar Rapids, IA 52401
Phone (319) 369-4542

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, 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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1396330288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 BOWLER ST",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331919",
            "telephone_number": "515-346-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 8TH AVE SE STE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012106",
            "telephone_number": "319-369-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLBERG",
        "first_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "105900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.