Sophie Pouliot

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

122671 Issued in IA

Practice address

1215 Pleasant St Ste 608
Des Moines, IA 50309-1418

Phone

(515) 875-9560

Fax

(515) 875-9561

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Physician Assistant

Education

Midwestern University, Chicago College of Osteopathic Med, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint Health - Des Moines Iowa Methodist Medi Hospital, Des Moines, IA, CCN 160082

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: spouliot1048078@direct.unitypoint.org
• Direct secure messaging: sophiepouliot@tic.allscriptsdirect.net

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.

• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1356433049
  Care Compare affiliation
• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1396837951
  Care Compare affiliation
• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1598905762
  Care Compare affiliation

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1538880778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 PLEASANT ST STE 608",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091418",
            "telephone_number": "515-875-9560",
            "fax_number": "515-875-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "SOPHIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2024-02-20",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "122671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sophiepouliot@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1215 Pleasant St Ste 608",
            "city": "Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "503091418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tristin Potratz, LMHC
• Daniel Ephraim Pott-Pepperman, PSY.D.
• Vali Potter, RPH
• Russell Adair Potts, D.D.S.
• Shardul Poudyal, MD
• Kavita Powaria, MD
• Abigail Powell
• Catherine Powell
• Lexy Shantel Powell, DO
• Luke Powell, ARNP

• Physician Assistant in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.