NPIMap

Individual provider Active NPI

Jason A. Huisenga, D.O.

  • Family Medicine Physician
  • Storm Lake, IA
National Provider Identifier
1609098649
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38213 Issued in IA
Practice address
2015 W 5TH St
Storm Lake, IA 50588-3000
Phone
(712) 732-6650
Fax
(712) 732-6632
NPI assigned
May 2, 2007
Last updated
Dec 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38213 IA Primary

Addresses

Primary practice location

2015 W 5TH St
Storm Lake, IA 50588-3000

Mailing address

24 N 9TH St
Suite a
Fort Dodge, IA 50501-3905
Phone (515) 574-6890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071103000006 IA Practitioner - Family Practice 2668569989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians
Sports Rehab and Professional Therapy Associates IncGroup PAC ID 1658289608, 124 clinicians

Practice addresses (Care Compare)

1525 W 5TH St
Buena Vista Regional Medical Center
Storm Lake, IA 50588-3027
Phone (712) 732-4030

315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center CurrentSince May 1, 2018 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Buena Vista Regional Medical Center Past Accepting new patients
Methodist Manor Retirement Community PastSince Jan 1, 2024 Accepting new patients

Locations

24 N 9th St
Ste A
Fort Dodge, IA 50501

800 Kenyon Rd
Ste S
Fort Dodge, IA 50501
Phone (515) 573-4141

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

1010 15th St N
Humboldt, IA 50548
Phone (515) 332-2015

2015 W 5th St
Storm Lake, IA 50588
Phone (717) 732-6650

Interoperability endpoints

  • Direct secure messaging: jhuisenga158534@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Methodist Manor Retirement CommunityStorm Lake, IA, CCN 165359 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024
Unitypoint Clinic Family Health Center - Storm LakeStorm Lake, IA, CCN 168613 Rural health clinic Contracted Managing Employee
Operational/Managerial Control		 Sep 2, 2019
Sep 2, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1609098649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N 9TH ST",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505013905",
            "telephone_number": "515-574-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W 5TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505883000",
            "telephone_number": "712-732-6650",
            "fax_number": "712-732-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUISENGA",
        "first_name": "JASON",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "38213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

Verify at the official NPI Registry.