Organization Active NPI

Medical Arts Associates, LTD.

  • Internal Medicine Physician
  • Moline, IL
National Provider Identifier
1396724183
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL ARTS ASSOCIATES, LTD.
Practice address
600 John Deere Rd
Suite 200
Moline, IL 61265-6869
Phone
(309) 779-4200
Fax
(309) 779-4305
NPI assigned
Jan 11, 2006
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Catherine A Levsen
Title
Administrator
Phone
(309) 779-4200

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU
MOHS-Micrographic Surgery Physician 207ND0101X NU
Internal Medicine Physician 207R00000X NU Primary
Hematology & Oncology Physician 207RH0003X NU
Pulmonary Disease Physician 207RP1001X NU
Obstetrics & Gynecology Physician 207V00000X NU
Neurology Physician 2084N0400X NU
Diagnostic Radiology Physician 2085R0202X NU
Diagnostic Ultrasound Physician 2085U0001X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

600 John Deere Rd
Suite 200
Moline, IL 61265-6869

Mailing address

600 John Deere Rd
Suite 200
Moline, IL 61265-6869
Phone (309) 779-4200

Other identifiers 1

IdentifierTypeStateIssuer
8115563OtherILBLUE SHIELD IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031203000420 IL Part B Supplier - Clinic/Group Practice 4385549377 Receives reassigned benefits from 24 practitioners
Practice locations: Moline, IL; Rock Island, IL
O20171203000001 IL DME Supplier - Physician - General SurgeryDME Supplier - Physician - Podiatry 4385549377 Practice locations: Moline, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0430744Medical Arts Associates, LTD600 John Deere Rd - Suite 200, Moline, IL 61265ComplianceNov 30, 2027

National Provider Directory

National Provider Directory

Locations

600 John Deere Rd
Ste 102
Moline, IL 61265
Phone (309) 779-4200

2701 17th St
#A
Rock Island, IL 61201
Phone (309) 779-4270

2701 17th St
Ste A
Rock Island, IL 61201
Phone (309) 779-4270

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1396724183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD",
            "address_2": "SUITE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656869",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD",
            "address_2": "SUITE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656869",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "LEVSEN",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-779-4200"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD IL",
            "identifier": "8115563",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.