NPIMap

Individual provider Active NPI

Robert M Pettis, M.D.

  • Otolaryngology Physician
  • Oskaloosa, IA
National Provider Identifier
1427082346
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD-55115 Issued in IA
Practice address
1229 C Ave E
Oskaloosa, IA 52577-4298
Phone
(641) 672-3394
Fax
(949) 337-4464
NPI assigned
Jul 10, 2006
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD-55115 IA Primary

Addresses

Primary practice location

1229 C Ave E
Oskaloosa, IA 52577-4298

Mailing address

1229 C Ave E
Oskaloosa, IA 52577-4298
Phone (641) 672-3394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051212000897 CA Practitioner - OtolaryngologyPractitioner - Family Practice 8921029414 Reassigns benefits to 2 organizations
I20250903001945 IA Practitioner - Otolaryngology 8921029414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, Geffen School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mahaska County HospitalGroup PAC ID 2769388677, shared by 6 NPIs, 128 clinicians
Orange Coast Head and Neck SurgeryGroup PAC ID 5597087601, 3 clinicians
Adventist Health Mendocino CoastGroup PAC ID 3678990769, 57 clinicians

Practice addresses (Care Compare)

1229 C Ave E
Mahaska Health
Oskaloosa, IA 52577-4298
Phone (641) 672-3100

155 Cypress St
Suite B
Fort Bragg, CA 95437-5401
Phone (949) 715-0500

700 River Dr
Fort Bragg, CA 95437-5403
Phone (707) 961-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-55115IAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Adventist Health Mendocino Coast CurrentSince Mar 3, 2022 Accepting new patients
Mahaska County Hospital Current Accepting new patients
Mahaska County Hospital CurrentSince Jul 28, 2025 Accepting new patients
Orange Coast Head and Neck Surgery Otolaryngology Current Accepting new patients
Orange Coast Head and Neck Surgery Otolaryngology CurrentSince Jul 20, 2014 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Valley Children's Specialty Medical Group, Inc. Past Accepting new patients
Orange Coast Fyzical PastSince Aug 14, 2022 Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
Mahaska County Hospital Past Accepting new patients

Locations

155 Cypress St
Ste B
Fort Bragg, CA 95437
Phone (949) 715-0500

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

16100 Sand Canyon Ave
Ste 230
Irvine, CA 92618
Phone (949) 653-7000

31862 Coast Hwy
Ste 302
Laguna Beach, CA 92651
Phone (949) 499-2080

1229 C Ave E
Oskaloosa, IA 52577
Phone (641) 672-3100

201 Trueblood Ave
Oskaloosa, IA 52577
Phone (641) 672-3360

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/29a5ccea-f4ab-4447-a191-56b20695970f/
  • Direct secure messaging: rpettis1200605@direct.unitypoint.org

Organizations & group practices 12

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 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1427082346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 C AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525774298",
            "telephone_number": "641-672-3394",
            "fax_number": "641-672-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 C AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525774298",
            "telephone_number": "641-672-3394",
            "fax_number": "949-337-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "MD-55115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oskaloosa, IA

Sources for this page

Verify at the official NPI Registry.