Active NPI
Heartland Plastic and Reconstructive Surgery P.C.
- Specialist
- Des Moines, IA
National Provider Identifier
1629104518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 26965
- Legal business name
- HEARTLAND PLASTIC AND RECONSTRUCTIVE SURGERY P.C.
- Practice address
- 10611 Hickman Rd
Des Moines, IA 50322-3731 - Phone
- (515) 254-2265
- Fax
- (515) 254-2272
- NPI assigned
- Feb 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eugene J Cherny, MD
- Title
- President
- Phone
- (515) 254-2265
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 26965 | IA | Primary |
Addresses
Primary practice location
10611 Hickman Rd
Des Moines, IA 50322-3731
Mailing address
10611 Hickman Rd
Des Moines, IA 50322-3731
Phone (515) 254-2265
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0423319 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
National Provider Directory
National Provider DirectoryOwnership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Ambulatory Surgical Clinic/Center
- Des Moines, IA
- NPI 1134857188
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Specialist
- Des Moines, IA
- NPI 1376679357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1629104518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10611 HICKMAN RD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503223731",
"telephone_number": "515-254-2265",
"fax_number": "515-254-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10611 HICKMAN RD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503223731",
"telephone_number": "515-254-2265",
"fax_number": "515-254-2272"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEARTLAND PLASTIC AND RECONSTRUCTIVE SURGERY P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CHERNY",
"authorized_official_first_name": "EUGENE",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "515-254-2265",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "IA",
"license": "26965",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0423319",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.