NPIMap

Individual provider Active NPI

Mordechai D Lederman, DO

  • Family Medicine Physician
  • Postville, IA
National Provider Identifier
1396741385
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3308 Issued in IA
Practice address
111 S Reynolds St
Postville, IA 52162-7737
Phone
(563) 864-7512
NPI assigned
Jun 23, 2005
Last updated
Mar 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3308 IA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816001069 IA Practitioner - Family PracticePractitioner - Emergency Medicine 0840263091 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmer Lutheran Health Center IncGroup PAC ID 4284544255, shared by 10 NPIs, 37 clinicians
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3308IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Jul 1, 2003 Accepting new patients
Palmer Lutheran Health Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Gundersen Clinic LTD CurrentSince Jul 1, 2003 Accepting new patients
Palmer Lutheran Health Center, Inc. Family Medicine CurrentSince Sep 1, 2000 Accepting new patients
The Evangelical Lutheran Good Samaritan Society Family Medicine PastSince Nov 13, 2017 Accepting new patients
Heart of the Valley Healthcare PC PastSince Jul 31, 2006 Accepting new patients
Gundersen Clinic, LTD. 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

  • FHIR API: https://api.platform.athenahealth.com/10294/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mlederman7447@direct.emplifyhealth.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gundersen Palmer Lutheran Hospital and ClinicsWest Union, IA, CCN 16Z316 Hospital Corporate Director Jul 31, 2015
Good Samaritan Society - West UnionWest Union, IA, CCN 165187 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 13, 2017
Nov 13, 2017
Good Samaritan Society - WaukonWaukon, IA, CCN 165240 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2020
Jan 1, 2020
Maple Crest ManorFayette, IA, CCN 165437 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 6

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1396741385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S REYNOLDS ST",
            "city": "POSTVILLE",
            "state": "IA",
            "postal_code": "521627737",
            "telephone_number": "563-864-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "MORDECHAI",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Postville, IA

Sources for this page

Verify at the official NPI Registry.