Active NPI
Steven G Paulsrud, D.O.
- Family Medicine Physician
- Muscatine, IA
National Provider Identifier
1558348284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02954
- Practice address
- 1616 Cedar St
Muscatine, IA 52761-3475 - Phone
- (563) 262-4101
- NPI assigned
- Dec 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02954 | IA | Primary |
Addresses
Primary practice location
1616 Cedar St
Muscatine, IA 52761-3475
Mailing address
1616 Cedar St
Muscatine, IA 52761-3453
Phone (563) 262-4101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5111609 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02954 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389744000000",
"number": "1558348284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 CEDAR ST",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613453",
"telephone_number": "563-262-4101",
"fax_number": "563-264-9513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 CEDAR ST",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613475",
"telephone_number": "563-262-4101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSRUD",
"first_name": "STEVEN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2014-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "02954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5111609",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muscatine, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.