Individual provider Active NPI

Jeffrey Claude Neitzel, DO

  • Surgical Critical Care Physician
  • Des Moines, IA
National Provider Identifier
1487952628
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
DO-05371 Issued in IA
Practice address
411 Laurel St Ste 3250
Des Moines, IA 50314-3026
Phone
(515) 643-6400
Fax
(515) 643-5816
NPI assigned
Mar 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X DO-05371 IA
Surgical Critical Care Physician 2086S0102X 288058 NY
Trauma Surgery Physician 2086S0127X 288058 NY
Surgical Critical Care Physician 2086S0102X DO-05371 IA Primary

Addresses

Primary practice location

411 Laurel St Ste 3250
Des Moines, IA 50314-3026

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-6400

Other practice location 1

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456

Other practice location 2

128 Willow Run Rd
Mount Orab, OH 45154-8001
Phone (937) 515-4859

Other practice location 3

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456

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
I20190528001239 IA Practitioner - General SurgeryPractitioner - Other (Physician) 9739451022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-4240

204 N 4TH Ave E
Newton, IA 50208-3135

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

411 Laurel St
Des Moines, IA 50314-3027

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083
  • Mercyone Newton Medical Center Hospital, Newton, IA, CCN 160032
  • Mary Greeley Medical Center Hospital, Ames, IA, CCN 160030
  • Guthrie County Hospital Hospital, Guthrie Center, IA, CCN 161314
  • Greater Regional Medical Center Hospital, Creston, IA, CCN 161365

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-05371IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince May 15, 2019 Accepting new patients
Mercy Clinics, Inc Surgery CurrentSince May 15, 2019 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Catholic Health Initiatives-Iowa Corp Past Accepting new patients

Locations

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

411 Laurel St
Ste 3250
Des Moines, IA 50314
Phone (515) 643-6400

300 N 4th Ave E
Ste 222
Newton, IA 50208
Phone (515) 358-0011

Interoperability endpoints

  • Direct secure messaging: jneitzel3953150@direct.trinity-health.org

Organizations & group practices 4

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 8

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": "1299888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1487952628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-6400",
            "fax_number": "515-643-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE 3250",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143026",
            "telephone_number": "515-643-6400",
            "fax_number": "515-643-5816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "133261301",
            "country_code": "US",
            "telephone_number": "607-547-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Willow Run Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Orab",
            "state": "OH",
            "postal_code": "451548001",
            "country_code": "US",
            "telephone_number": "937-515-4859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "133261301",
            "country_code": "US",
            "telephone_number": "607-547-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEITZEL",
        "first_name": "JEFFREY",
        "middle_name": "CLAUDE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-12",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "DO-05371",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "288058",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NY",
            "license": "288058",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IA",
            "license": "DO-05371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.