Individual provider Active NPI

Jeremy Macvarish

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1629637996
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
097834 Issued in IA
Practice address
1111 6TH Ave Ste B1
Des Moines, IA 50314-2610
Phone
(515) 358-0100
Fax
(515) 358-0109
NPI assigned
Jun 11, 2019
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 097834 IA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1111 6TH Ave Ste B1
Des Moines, IA 50314-2610

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-0100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191002000119 IA Practitioner - Physician Assistant 6800126087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2610

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-4240

1111 6TH Ave E Tower
Des Moines, IA 50314-2610

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
097834IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Sep 18, 2019 Accepting new patients
Mercy Clinics, Inc. Physician Assistant Past Accepting new patients

Locations

1111 6th Ave
Ste B1
Des Moines, IA 50314
Phone (515) 358-0100

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

Interoperability endpoints

  • Direct secure messaging: jmacvarish3950653@direct.trinity-health.org

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 4

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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1629637996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE STE B1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142610",
            "telephone_number": "515-358-0100",
            "fax_number": "515-358-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACVARISH",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "097834",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.