Mercy Physician Associates, Inc
Organization Active NPI Family Medicine Physician · Cedar Rapids, IA
NPI 1497952170 · NPPES record last updated Apr 5, 2017
Key facts
- NPI
- 1497952170
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MERCY PHYSICIAN ASSOCIATES, INC
- Practice address
- 600 7TH St SE Ste 100
Cedar Rapids, IA 52401-2120 - Phone
- (319) 369-4798
- NPI assigned
- Jun 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Annette J Stanton
- Title
- Sr Director
- Phone
- (319) 369-4512
Other NPIs on the same Medicare enrollment 29
Corporate family (same tax ID) 14
Practitioners 3
-
Thomas Gregory Drahos, PA-C
-
Jessica Quinn, PAC
-
Vincent A Taeger, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0386943 | Mercycare Medical District | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040120000805 | IA | Part B Supplier - Clinic/Group Practice | 1355242496 |
Receives reassigned benefits from 135 practitioners 36 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Central City, IA; Cedard Rapids, IA; Hiawatha, IA; Manchester, IA; Marengo, IA; Marion, IA; Monticello, IA; Mt Vernon, IA… |
National Provider Directory
- Tax ID family
- Ceder Rapids Community
Locations
600 7th St SE
Ste 100
Cedar Rapids, IA 52401
Phone (319) 363-2929
1444 2nd Ave SE
Cedar Rapids, IA 52403
Phone (319) 363-2929
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
600 7TH St SE Ste 100
Cedar Rapids, IA 52401-2120
Mailing address
PO Box 1824
Cedar Rapids, IA 52406-1824
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0792531 | Medicaid | IA | |
| 0792523 | Medicaid | IA |
Other names
- MercyCare Medical District
Other providers in Cedar Rapids, IA
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
- Mercy Physician Associates, Inc
All providers in Cedar Rapids, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.