Anthony Avallone, MD
Individual provider Active NPI Urology Physician · West Des Moines, IA
NPI 1659328540 · NPPES record last updated Sep 6, 2019
Key facts
- NPI
- 1659328540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- MD-46514 (IA)
- Practice address
- 5950 University Ave Ste 341
West Des Moines, IA 50266-8289 - Phone
- (515) 875-9800
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME121181 | FL | MD | Urology Physician |
| MD-46514 | IA | MD | Urology Physician |
| 093641 | OH | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesiscare USA of Florida LLC | Urology | Past | Accepting new patients |
| Ozarks Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME121181 | FL | |
| Urology Physician | 208800000X | 093641 | OH | |
| Urology Physician | 208800000X | MD-46514 | IA | Yes |
Addresses
Primary practice location
5950 University Ave Ste 341
West Des Moines, IA 50266-8289
Mailing address
5950 University Ave Ste 321
West Des Moines, IA 50266-8289
Phone (515) 875-9255
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14W89 | Other | FL | BCBS |
| 380593 | Other | FL | AVMED |
| 5468012 | Other | FL | AETNA |
| P01451582 | Other | FL | RR MEDICARE ID # |
| 6269916 | Other | FL | CIGNA |
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- Beth Avery
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- Awaken to Change, P.C.
All providers in West Des Moines, IA · Urology Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.