Mordechai D Lederman, DO
Individual provider Active NPI Family Medicine Physician · Postville, IA
NPI 1396741385 · NPPES record last updated Mar 24, 2015
Key facts
- NPI
- 1396741385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 3308 (IA)
- Practice address
- 111 S Reynolds St
Postville, IA 52162-7737 - Phone
- (563) 864-7512
- NPI assigned
- Jun 23, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 6
Owned or controlled facilities with NPI records 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Palmer Lutheran Health Center Inc
Gundersen Clinic LTD
Practice addresses (Care Compare)
110 Jefferson St
West Union, IA 52175-1022
Phone (563) 422-3817
110 King St
Fayette, IA 52142-9735
Phone (563) 425-3381
111 S Reynolds
Postville, IA 52162-7737
Phone (319) 864-7512
111 S Reynolds St
Gundersen Palmer Postville
Postville, IA 52162-7737
Phone (563) 864-7512
112 Jefferson St
West Union, IA 52175-1022
Phone (563) 422-3811
120 2ND Ave SE
Waukon, IA 52172-2073
Phone (563) 568-3000
50 N 4TH St
Lansing, IA 52151-7729
Phone (563) 538-4874
Hospital & facility affiliations
- Gundersen Palmer Lutheran Hosp & Clin-Home Health
- Gundersen Palmer Lutheran Hosp and Clinics-Hospice
- Care Initiatives Hospice - Cedar Falls
- Gundersen Palmer Lutheran Hospital and Clinics
- Good Samaritan - West Union
- Maple Crest Manor
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Gundersen Palmer Lutheran Hospital and Clinics |
Hospital | Corporate Director | Jul 31, 2015 |
| Good Samaritan Society - West Union |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Nov 13, 2017 Nov 13, 2017 |
| Good Samaritan Society - Waukon |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2020 Jan 1, 2020 |
| Maple Crest Manor |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2024 Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040816001069 | IA | Practitioner - Family Practice |
0840263091 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3308 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmer Lutheran Health Center, Inc. | Family Medicine | Current |
Accepting new patients |
| Palmer Lutheran Health Center, Inc. | Current |
Accepting new patients | |
| Gundersen Clinic LTD | Current |
Accepting new patients | |
| Gundersen Lutheran Express Care, Inc | Current |
Accepting new patients | |
| Heart of the Valley Healthcare PC | Past |
Accepting new patients | |
| Gundersen Clinic, LTD. | Family Medicine | Past | Accepting new patients |
| The Evangelical Lutheran Good Samaritan Society | Family Medicine | Past |
Accepting new patients |
Locations
235 8th Ave W
Cresco, IA 52136
Phone (319) 547-2101
1014 Main St
Elgin, IA 52141
Phone (319) 426-5583
626 Main St
Mc Gregor, IA 52157
Phone (563) 873-3411
110 Jefferson St
West Union, IA 52175
Phone (319) 422-3817
112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
Interoperability endpoints
- mlederman7447@direct.emplifyhealth.org
- https://api.platform.athenahealth.com/10294/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3308 | IA | Yes |
Addresses
Primary practice location
111 S Reynolds St
Postville, IA 52162-7737
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300
Other providers in Postville, IA
- Gundersen Clinic, LTD.
- Katherine Helen Klinge
- Roger Whitman Kolarich
- Kristen Leigh Larter
- Heather Michelle Lechtenberg
- Thomas George McMullan
- C. Sue Mueller
- Palmer Lutheran Health Center, Inc.
- Postville Community Schools
- Prescription Shoppe Telepharmacy, LLC
All providers in Postville, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2015. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.