Individual provider Active NPI

Patrick J Kasper, PA

  • Physician Assistant
  • Urbandale, IA
National Provider Identifier
1407248370
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
077315 Issued in IA
Practice address
2901 86TH St
Urbandale, IA 50322-4201
Phone
(515) 276-3406
Fax
(515) 276-5141
NPI assigned
Mar 2, 2015
Last updated
Apr 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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 077315 IA Primary

Addresses

Primary practice location

2901 86TH St
Urbandale, IA 50322-4201

Mailing address

2901 86TH St
Urbandale, IA 50322-4201
Phone (515) 276-3406

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
I20150401000983 IA Practitioner - Physician Assistant 0446577423 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
077315IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Feb 23, 2015 Accepting new patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Feb 23, 2015 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

2901 86th St
Urbandale, IA 50322
Phone (515) 276-3406

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1407248370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 86TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224201",
            "telephone_number": "515-276-3406",
            "fax_number": "515-276-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 86TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224201",
            "telephone_number": "515-276-3406",
            "fax_number": "515-276-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPER",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "077315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.