NPIMap

Individual provider Active NPI

Stephanie Sam, DO

  • Hospitalist Physician
  • West Des Moines, IA
National Provider Identifier
1548780323
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DO-06706 Issued in IA
Practice address
1755 59TH PL
West Des Moines, IA 50266-7737
Phone
(515) 247-4240
Fax
(515) 247-4239
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 74020-21 WI
Hospitalist Physician 208M00000X DO-06706 IA Primary

Addresses

Primary practice location

1755 59TH PL
West Des Moines, IA 50266-7737

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 247-4240

Other practice location 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201006000545 WI Practitioner - Hospitalist 2961771829 Reassigns benefits to 1 organization
I20240723004262 IA Practitioner - Hospitalist 2961771829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2017
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)

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 358-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Sep 24, 2020 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc Hospitalist CurrentSince Jul 15, 2024 Accepting new patients
Mercy Clinics, Inc. CurrentSince Jul 15, 2024 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

1111 6th Ave
#3
Des Moines, IA 50314
Phone (515) 246-9320

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: ssam3957047@direct.trinity-health.org

Organizations & group practices 5

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 4

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1548780323",
    "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": "515-247-4240",
            "fax_number": "515-247-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 59TH PL",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667737",
            "telephone_number": "515-247-4240",
            "fax_number": "515-247-4239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142613",
            "country_code": "US",
            "telephone_number": "515-247-4240",
            "fax_number": "515-247-4239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "74020-21",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "DO-06706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.