Individual provider Active NPI

Kristin Gisselman, D.O.

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1467890988
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-9715 Issued in IA
Practice address
250 Laurel St
Des Moines, IA 50314-3024
Phone
(515) 643-4610
Fax
(515) 643-4662
NPI assigned
Jun 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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 R-9715 IA Primary

Addresses

Primary practice location

250 Laurel St
Des Moines, IA 50314-3024

Mailing address

250 Laurel St
Des Moines, IA 50314-3024
Phone (515) 643-4610

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150204000720 IA Practitioner - Family Practice 4587987375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians

Practice addresses (Care Compare)

3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869
Phone (319) 363-9118

Hospital & facility affiliations

  • Mercy Home Care Home health agency, Cedar Rapids, IA, CCN 167151
  • Aveanna Healthcare Home health agency, Hiawatha, IA, CCN 167313
  • Hospice of Mercy Hospice, Hiawatha, IA, CCN 161512
  • Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079
  • St Lukes Hospital Hospital, Cedar Rapids, IA, CCN 160045
  • Hallmar Village Nursing home, Cedar Rapids, IA, CCN 165798

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions21
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-9715IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Associates Inc Family Medicine CurrentSince Aug 1, 2016 Accepting new patients
Mercy Care Management, Inc Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Mercy Physician Associates, Inc Family Medicine CurrentSince Aug 1, 2016 Accepting new patients
Mercy Care Management, Inc Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Mercy Physician Associates, Inc Family Medicine Current Accepting new patients
Mercy Physician Associates, Inc Family Medicine Past Accepting new patients

Locations

3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403
Phone (319) 363-8148

5264 Council St NE
Ste 100
Cedar Rapids, IA 52402
Phone (319) 221-8444

1790 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 378-8362

300 W May St
Marengo, IA 52301
Phone (319) 462-8011

Organizations & group practices 6

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.

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1467890988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143024",
            "telephone_number": "515-643-4610",
            "fax_number": "515-643-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143024",
            "telephone_number": "515-643-4610",
            "fax_number": "515-643-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISSELMAN",
        "first_name": "KRISTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-9715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.