Iowa Diagnostic Imaging & Procedure Center, L C
Organization Active NPI Diagnostic Radiology Physician · Clive, IA
NPI 1528026481 · NPPES record last updated Jul 1, 2022
Key facts
- NPI
- 1528026481
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- IOWA DIAGNOSTIC IMAGING & PROCEDURE CENTER, L C
- Practice address
- 12368 Stratford Dr
Suite 300
Clive, IA 50325-8162 - Phone
- (515) 226-9810
- Fax
- (515) 226-8408
- NPI assigned
- May 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Cheri K. Tiedemann
- Title
- Billing Office Coordinator
- Phone
- (515) 961-0453
Member of 2
Practitioners 46
-
James J Choi, MD
-
Bradley King, DO
-
Eric E Luebbert, D.O.
-
Frederick B Steinberg, M.D.
-
Alan Barth Stone, M.D.
-
Jill Suzanne Westercamp, M.D.
-
Alex Charles Essenmacher, M.D.
-
Zachary Tyler Hill, D.O.
-
Jeffrey Rappleye, M.D.
-
Blake Steven Riebe, D.O.
-
Jordan Smith, DO
-
Scott W Wise, MD
-
Brian Paul Wynia, DO
-
Cassandra R Burch, PA-C
-
William Duncan Heggen, M.D.
-
Nicholas L Hilpipre, M.D.
-
Ryan L Holdsworth, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D1093195 | Iowa Diagnostic Imaging and Procedure Center | Certificate of waiver | Dec 10, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (9 enrollments) in IA, LA, MN, AK, HI, OK, MO, FL, KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040325001707 | IA | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 39 practitioners Practice locations: Clive, IA; West Des Moines, IA; Waukee, IA; Des Moines, IA; Ankeny, IA |
| O20180319002287 | LA | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Mandeville, LA |
| O20181022000882 | MN | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Woodbury, MN |
| O20181025001200 | AK | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Wasilla, AK |
| O20220706000322 | HI | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Honolulu, HI |
| O20230125001398 | OK | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Poteau, OK |
| O20241031002074 | MO | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Marshfield, MO |
| O20241220001622 | FL | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 2 practitioners Practice locations: Bonita Springs, FL |
| O20250328000580 | KS | Part B Supplier - Clinic/Group Practice | 1658263546 |
Receives reassigned benefits from 1 practitioner Practice locations: Leawood, KS |
National Provider Directory
Locations
1105 N Ankeny Blvd
Ste 200
Ankeny, IA 50023
12368 Stratford Dr
Clive, IA 50325
1221 Pleasant St
Des Moines, IA 50309
Phone (515) 241-4141
6000 University Ave
Ste 150
West Des Moines, IA 50266
4200 University Ave
Ste 104
West Des Moines, IA 50266
Phone (515) 961-0453
6000 University Ave
Ste 15
West Des Moines, IA 50266
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Mailing address
12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Phone (515) 226-9810
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0273326 | Medicaid | IA |
Other names
- Iowa Radiology, P.C.
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All providers in Clive, IA · Diagnostic Radiology 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 Jul 1, 2022. 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.