NPIMap

Organization Active NPI

State University of Iowa

Doing business as University of Iowa Health Care

  • Family Medicine Physician
  • Iowa City, IA
National Provider Identifier
1477554814
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STATE UNIVERSITY OF IOWA
Doing business as
University of Iowa Health Care
University of Iowa Hospitals & Clinics/Medical Service Plan
Practice address
200 Hawkins Dr
Iowa City, IA 52242
Phone
(319) 356-1616
Fax
(319) 384-5164
NPI assigned
Aug 9, 2005
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE UNIVERSITY OF IOWAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Douglas J Vandaele, MDNPI 1821082587
Title
Associate Dean
Phone
(319) 353-8162

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X IA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X IA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X IA
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X IA

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Other practice location 1

920 E 2nd Ave Ste 201A&b
Coralville, IA 52241-2219
Phone (319) 467-2000

Other practice location 2

105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000

Other practice location 3

2701 Prairie Meadow Dr
Iowa City, IA 52242-8001
Phone (319) 384-7070

Other names 2

  • University of Iowa Health Care Doing business as
  • University of Iowa Hospitals & Clinics/Medical Service Plan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, SD, WA, CA, PA, VA, TX, FL, WI, NJ, SC, MA, TN, AL, CT, NY, CO, MO, MI, MD, OR, AZ, UT, NE, DC, GA, MS, NC, NM, NH, KY32 enrollments

Enrollment records 32

Enrollment IDStateProvider typePAC IDDetails
O20031107000060 IA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2,348 practitioners
37 other NPIs on this enrollment
O20091221000403 IL Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Mettawa, IL; Western Springs, IL; Chicago, IL
O20140626002579 SD Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux Falls, SD
O20200818001184 WA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 7 practitioners
Practice locations: Wenatchee, WA; Seattle, WA; Bellingham, WA; Lake Tapps, WA; Clyde Hill, WA; Kirkland, WA; Anacortes, WA; Bellevue, WA
O20201020000616 CA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 6 practitioners
Practice locations: Vacaville, CA; Temecula, CA; Seal Beach, CA; Moorpark, CA; Laguna Woods, CA; Laguna Niguel, CA; Redondo Beach, CA
O20220510000048 PA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Wexford, PA
O20230201000752 VA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Ashburn, VA
O20230206003187 TX Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 6 practitioners
Practice locations: Alamo Heights, TX; Houston, TX; Katy, TX; Keller, TX; San Antonio, TX; Spring, TX; Sugar Land, TX
O20230306000360 FL Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 5 practitioners
Practice locations: Jacksonville, FL; Longwood, FL; Miami, FL; Orlando, FL; Tampa, FL; Valparaiso, FL
O20230927002975 WI Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Whitefish Bay, WI
O20231214001065 NJ Part B Supplier - Clinic/Group Practice 7618884230 Practice locations: Harvey Cedars, NJ; Livingston, NJ; Wyckoff, NJ
O20240108000661 SC Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Charleston, SC
O20240109000130 MA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 6 practitioners
Practice locations: Belmont, MA; Winchester, MA; Newburyport, MA; Needham, MA; Natick, MA; Boston, MA; Amherst, MA
O20240307001096 TN Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Brentwood, TN
O20240307001678 AL Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 3 practitioners
Practice locations: Auburn, AL; Birmingham, AL; Indian Springs, AL
O20240314001874 CT Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: New Canaan, CT
O20240314002768 NY Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 5 practitioners
Practice locations: Brooklyn, NY; New York, NY; Buffalo, NY
O20240403003040 CO Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 14 practitioners
Practice locations: Englewood, CO; Parker, CO; Monument, CO; Highlands Ranch, CO; Denver, CO; Castle Pines, CO; Almont, CO
O20240404000204 MO Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 3 practitioners
Practice locations: Jefferson City, MO; Lees Summit, MO; Riverside, MO
O20240404002510 MI Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: West Bloomfield, MI
O20240518000402 MD Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2 practitioners
Practice locations: Annapolis, MD; Lutherville, MD
O20240614002033 OR Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Eugene, OR
O20240701003498 AZ Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 6 practitioners
Practice locations: Tempe, AZ; Scottsdale, AZ; Phoenix, AZ; Peoria, AZ; Oro Valley, AZ; Avondale, AZ
O20240709002661 UT Part B Supplier - Clinic/Group Practice 7618884230 Practice locations: Woodland Hills, UT
O20240716002484 NE Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE
O20240910003659 DC Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 4 practitioners
Practice locations: Arlington, VA; Gaithersburg, MD; MC Lean, VA; Potomac, MD
O20241106000329 GA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 3 practitioners
Practice locations: Atlanta, GA; Savannah, GA
O20241204004389 MS Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS
O20250123001460 NC Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2 practitioners
Practice locations: Burnsville, NC; Durham, NC
O20250214003369 NM Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM
O20251218002897 NH Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2 practitioners
Practice locations: Stratham, NH; Henniker, NH
O20251231001385 KY Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 1 practitioner
Practice locations: Bowling Green, KY

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

National Provider Directory

National Provider Directory
Part of
Brian W Omeara MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 95)

2181 Kalakaua Ave
Honolulu, HI 96815
Phone (213) 309-8948

1215 Duff Ave
Ames, IA 50010
Phone (515) 239-4400

1905 SW Magazine Rd
Ankeny, IA 50023

1950 SW Magazine Rd
#U
Ankeny, IA 50023
Phone (515) 237-7066

1351 Kimberly Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-7733

204 W 7th St
#U
Carroll, IA 51401
Phone (712) 792-5530

726 N Carroll St
Ste 1
Carroll, IA 51401
Phone (712) 792-5530

1224 13th St NW
Cedar Rapids, IA 52405
Phone (319) 365-9171

1231 Park Pl NE
#U
Cedar Rapids, IA 52402
Phone (319) 363-3600

1 Saint Joseph Dr
#U
Centerville, IA 52544
Phone (641) 437-3482

1663 Lincoln Way
Ste De
Clinton, IA 52732
Phone (563) 243-0292

1663A Lincoln Way
#U
Clinton, IA 52732
Phone (563) 243-0292

1663A Lincoln Way
Ste De
Clinton, IA 52732
Phone (563) 243-0292

12495 University Ave
Ste 200
Clive, IA 50325
Phone (515) 223-6605

2055 Oakdale Rd
#U
Coralville, IA 52241
Phone (319) 248-0037

2450 Coral Ct
#U
Coralville, IA 52241
Phone (319) 645-3300

2769 Heartland Dr
Ste 203
Coralville, IA 52241
Phone (319) 688-7517

920 E 2nd Ave
Ste 201
Coralville, IA 52241
Phone (319) 384-7000

920 E 2nd Ave
Ste 2018
Coralville, IA 52241

920 E 2nd Ave
Ste 201B
Coralville, IA 52241
Phone (319) 467-2000

806 Wyoming Ave
Creston, IA 50801
Phone (641) 782-9500

1230 E Rusholme St
Ste 305
Davenport, IA 52803
Phone (563) 421-3030

16773 State Highway 2
#U
Decatur, IA 50067
Phone (641) 782-9500

911 S Mill St
Ste 6
Decorah, IA 52101
Phone (563) 382-1277

110 E Court Ave
Ste 120
Des Moines, IA 50309
Phone (515) 237-7023

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
University of Iowa Health Care Medical CenterIowa City, IA, CCN 160058 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical CenterIowa City, IA, CCN 16S058 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical Center DowntownIowa City, IA, CCN 160029 Hospital Other Jan 31, 2024
University of Iowa Health Care Medical Center Downtown Home HealthCoralville, IA, CCN 167181 Home health agency Other Jan 31, 2024

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 2,697

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 2,697

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1477554814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616",
            "fax_number": "319-384-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-356-1616",
            "fax_number": "319-384-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 E 2nd Ave Ste 201A&b",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412219",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412209",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 Prairie Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522428001",
            "country_code": "US",
            "telephone_number": "319-384-7070",
            "fax_number": "319-467-8247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE UNIVERSITY OF IOWA",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "VANDAELE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSOCIATE DEAN",
        "authorized_official_telephone_number": "319-353-8162",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "IA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Iowa Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Iowa Hospitals & Clinics/Medical Service Plan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.