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

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

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1093195Iowa Diagnostic Imaging and Procedure Center
12368 Stratford Drive, Clive, IA 50325
Certificate of waiverDec 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 IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
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

IdentifierTypeStateIssuer
0273326MedicaidIA

Other names

  • Iowa Radiology, P.C. Doing business as

Other providers in Clive, IA

All providers in Clive, IA · Diagnostic Radiology Physician in Iowa

Sources for this page

Verify at the official NPI Registry.