Cedar Valley Medical Specialists PC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Waterloo, IA
NPI 1568417293 · NPPES record last updated Feb 5, 2026
Key facts
- NPI
- 1568417293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- CEDAR VALLEY MEDICAL SPECIALISTS PC
- Practice address
- 909 E San Marnan Dr
Waterloo, IA 50702-5611 - Phone
- (319) 233-2020
- Fax
- (319) 268-3737
- NPI assigned
- May 23, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CEDAR VALLEY MEDICAL SPECIALISTS PC
Authorized official
- Name
- Vinay Kantamneni, MD
- Title
- Ceo
- Phone
- (319) 235-5390
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 5
Practitioners 61
-
Ashar Afzal, MD
-
Madison Ann Albert, ARNP
-
Taha Ashraf, M.D
-
Kama Sarah Ausborn, ARNP
-
Jane Marie Baker, ARNP
-
Ivo Bekavac, MD PHD
-
Staci Anne Boon, O.D.
-
Katie Marie Bries, ARNP
-
Barbara K Burkle, ARNP
-
Kirby P Clark, M.D.
-
Emily Clinton, ARNP
-
Maryjane Cose, ARNP
-
Suzanne Craver Davison, ARNP
-
Joud Ghassoub Dib, M.D.
-
Cari Graham, PT
-
Gregory K Harter, MD
-
James Corye Johnson, LISW
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2064364 | Cedar Valley Medical Specialists, PC | Certificate of waiver | Aug 18, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Cedar Valley Medical Specialists PC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930015064 | IA | DME Supplier - Physician - Optometrist |
1759291487 | Practice locations: Waterloo, IA |
National Provider Directory
- Tax ID family
- Cedar Valley Med Specia
- Part of
- Cedar Valley Med Specia
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
909 E San Marnan Dr
Waterloo, IA 50702-5611
Mailing address
PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0283341 | Medicaid | IA |
Other providers in Waterloo, IA
- Cedar Valley Center for Expressive Arts Therapy
- Cedar Valley Community Support Services
- Cedar Valley Endodontics, LLC
- Cedar Valley Hospice, Inc.
- Cedar Valley Medical Specialists PC
- Cedar Valley Medical Specialists PC
- Cedar Valley Medical Specialists PC
- Cedar Valley Mobility, LLC
- Cedar Valley Ophthalmology PC
- Cedar Valley Sleep Center
All providers in Waterloo, IA · Durable Medical Equipment & Medical Supplies in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2026. 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.