Individual provider Active NPI

Brian Edeker, MD

  • Emergency Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1619937638
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31830 Issued in IA
Practice address
701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone
(319) 398-6297
Fax
(319) 398-6249
NPI assigned
Mar 24, 2006
Last updated
Feb 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31830 IA Primary

Addresses

Primary practice location

701 10TH St SE
Cedar Rapids, IA 52403-1251

Mailing address

PO Box 5610
Cedar Rapids, IA 52406-5610
Phone (319) 369-4505

Other identifiers 1

IdentifierTypeStateIssuer
1157610MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100426000007 IA Practitioner - Emergency Medicine 2668560046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson County Emergency Medicine PLCGroup PAC ID 6901231810, 29 clinicians

Practice addresses (Care Compare)

1195 Boyson Rd
Suite 101
Hiawatha, IA 52233-2218
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-0300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Linn County Emergency Medicine PC Emergency Medicine CurrentSince Nov 1, 1998 Accepting new patients
Johnson County Emergency Medicine, PLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine CurrentSince Nov 1, 1998 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

1195 Boyson Rd
Ste 101
Hiawatha, IA 52233
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245
Phone (319) 339-0300

999 35th St
Marion, IA 52302

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

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1619937638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5610",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524065610",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-398-6297",
            "fax_number": "319-398-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEKER",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "31830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1157610",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.