Kevin Peter Riesselman, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

119180 Issued in IA

Practice address

6000 Aurora Ave
Des Moines, IA 50322-2837

Phone

(515) 883-1776

NPI assigned

Jul 7, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Iowa, RJ & L Carver College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CsaGroup PAC ID 9335509322, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Csa

  • Community/Behavioral Health Agency
  • West Des Moines, IA
  • NPI 1427390061
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1407534746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 MARIANNA TRL",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104847",
            "telephone_number": "515-419-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 AURORA AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503222837",
            "telephone_number": "515-883-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESSELMAN",
        "first_name": "KEVIN",
        "middle_name": "PETER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "119180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna L W Ridlen, D.O.
• Terry Rae Rieck, D.D.S.
• Janet Lynn Rieckhoff, MS
• Angie Riepe, L.M.S.W.
• Alex Rier, MD
• Anna Kathleen Riessen, M.D.
• Jared L Rietveld, DO
• Jenn Riggs
• Bradley J Riley, MD
• Gabriella Vivian Riley

• Clinical Social Worker in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.