Individual provider Active NPI

Dylan Roberts Streb, DO

  • Family Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1619404613
Registry record updated May 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-10827 Issued in IA
Practice address
Eastern Iowa Health Center
1201 Third Avenue SE
Cedar Rapids, IA 52403
Phone
(319) 730-7300
Fax
(319) 730-7368
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 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 R-10827 IA Primary

Addresses

Primary practice location

Eastern Iowa Health Center
1201 Third Avenue SE
Cedar Rapids, IA 52403

Mailing address

Eastern Iowa Health Center
1201 Third Avenue SE
Cedar Rapids, IA 52403
Phone (319) 730-7300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200513002357 MI Practitioner - Family Practice 7810266889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherry Street Services IncGroup PAC ID 6800707647, 58 clinicians

Practice addresses (Care Compare)

100 Cherry St SE
Grand Rapids, MI 49503-4526

550 Cherry St SE
Grand Rapids, MI 49503-4748
Phone (616) 235-7272

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-10827IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Street Services, Inc. Family Medicine CurrentSince May 6, 2020 Accepting new patients
Cherry Street Services, Inc CurrentSince May 6, 2020 Accepting new patients
Cherry Street Health Services Past Accepting new patients

Locations

669 Stocking Ave NW
Grand Rapids, MI 49504
Phone (616) 235-1480

100 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 965-8209

550 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 235-7272

1003 N Lafayette St
Greenville, MI 48838
Phone (616) 225-9650

Interoperability endpoints

  • Direct secure messaging: dylan.streb.p1@direct.cherryhealth.nextgenshare.com

Organizations & group practices 3

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 2

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1619404613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EASTERN IOWA HEALTH CENTER",
            "address_2": "1201 THIRD AVENUE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-730-7300",
            "fax_number": "319-730-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EASTERN IOWA HEALTH CENTER",
            "address_2": "1201 THIRD AVENUE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-730-7300",
            "fax_number": "319-730-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREB",
        "first_name": "DYLAN",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-10827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.