Individual provider Active NPI

Donald M Kaesser, PH. D.

  • Counseling Psychologist
  • Des Moines, IA
National Provider Identifier
1487745402
Registry record updated Mar 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
00550 Issued in IA
Practice address
1922 Ingersoll Ave
Des Moines, IA 50309-3321
Phone
(515) 240-7997
Fax
(515) 282-5570
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00550 IA
Health Service Psychologist 103TH0100X 00166 IA
Counseling Psychologist 103TC1900X 00550 IA Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 00550 IA

Addresses

Primary practice location

1922 Ingersoll Ave
Des Moines, IA 50309-3321

Mailing address

1922 Ingersoll Ave
Des Moines, IA 50309-3321
Phone (515) 240-7997

Other identifiers 1

IdentifierTypeStateIssuer
0047894MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000454 IA Practitioner - Clinical Psychologist 1850349861

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00550IAMDCounseling Psychologist
00166IAMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Counseling Solutions Inc. PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425686400000",
    "number": "1487745402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093321",
            "telephone_number": "515-240-7997",
            "fax_number": "515-282-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093321",
            "telephone_number": "515-240-7997",
            "fax_number": "515-282-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAESSER",
        "first_name": "DONALD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00550",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IA",
            "license": "00166",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IA",
            "license": "00550",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "00550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0047894",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.