NPIMap

Individual provider Active NPI

Michele L Dikkers, D.O.

  • Family Medicine Physician
  • Guttenberg, IA
National Provider Identifier
1609865435
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03015 Issued in IA
Practice address
200 Main Street
Guttenberg, IA 52052
Phone
(563) 252-1121
Fax
(563) 252-3955
NPI assigned
Oct 14, 2005
Last updated
Apr 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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 03015 IA Primary

Addresses

Primary practice location

200 Main Street
Guttenberg, IA 52052

Mailing address

PO Box 550
Guttenberg, IA 52052-0550
Phone (563) 252-1121

Other identifiers 2

IdentifierTypeStateIssuer
1142539MedicaidIA
IB2804006OtherIAPTAN

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
I20100524000088 IA Practitioner - Family Practice 5890861751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guttenberg Municipal HospitalGroup PAC ID 6901709476, shared by 6 NPIs, 24 clinicians

Practice addresses (Care Compare)

200 Main St
Guttenberg, IA 52052-9108
Phone 56325211211361

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03015IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Guttenberg Municipal Hospital Current Accepting new patients
Guttenberg Municipal Hospital CurrentSince Dec 1, 2012 Accepting new patients
Guttenberg Municipal Hospital Family Medicine CurrentSince Dec 1, 2012 Accepting new patients
Guttenberg Municipal Hospital CurrentSince Dec 1, 2012 Accepting new patients
Family Medicine Associates PC Family Medicine PastSince Sep 1, 1998 Accepting new patients
Guttenberg Municipal Hospital Past Accepting new patients
Guttenberg Municipal Hospital Past Accepting new patients

Locations

101 S Washington St
Edgewood, IA 52042
Phone (563) 252-1121

200 Main St
Guttenberg, IA 52052
Phone (563) 252-1121

Interoperability endpoints

  • Direct secure messaging: msadler143721@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Guttenberg Care CenterGuttenberg, IA, CCN 165334 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 15, 2024
Aug 15, 2024

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 8

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 6

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1609865435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "520520550",
            "telephone_number": "563-252-1121",
            "fax_number": "563-252-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN STREET",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "52052",
            "telephone_number": "563-252-1121",
            "fax_number": "563-252-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIKKERS",
        "first_name": "MICHELE",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1142539",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IB2804006",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guttenberg, IA

Sources for this page

Verify at the official NPI Registry.