NPIMap

Individual provider Active NPI

Jason R Koelewyn, MD

  • Family Medicine Physician
  • Sioux Center, IA
National Provider Identifier
1659592020
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37667 Issued in IA
Practice address
1101 9TH St SE
Sioux Center, IA 51250-2501
Phone
(712) 722-2609
Fax
(712) 722-4325
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 37667 IA Primary

Addresses

Primary practice location

1101 9TH St SE
Sioux Center, IA 51250-2501

Mailing address

1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (712) 722-2609

Other practice location 1

645 S Main Ave
Sioux Center, IA 51250-1347
Phone (712) 722-2609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080812000837 IA Practitioner - Family Practice 2961595608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sioux Center HealthGroup PAC ID 9032027495, shared by 6 NPIs, 36 clinicians

Practice addresses (Care Compare)

1101 9TH St SE
Sioux Center Health Medical Clinic
Sioux Center, IA 51250-2501
Phone (712) 722-1271

Hospital & facility affiliations

  • Sioux Center Home Health and Hospice Home health agency, Sioux Center, IA, CCN 167164
  • Sioux Center Health Home Care and Hospice Hospice, Sioux Center, IA, CCN 161519
  • Sioux Center Health Hospital, Sioux Center, IA, CCN 161346
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Crown Pointe Estates Care Center Nursing home, Sioux Center, IA, CCN 165157
  • Sioux Center Health Nursing home, CCN 16Z346

Merit-based Incentive Payment System (MIPS)

Final score
95.27 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37667IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sioux Center Health Current Accepting new patients
Sioux Center Health Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
Sioux Center Health CurrentSince Sep 1, 2008 Accepting new patients

Locations

807 Main St
Ste D
Hull, IA 51239
Phone (712) 439-1315

1101 9th St SE
Sioux Center, IA 51250
Phone (712) 722-1271

Interoperability endpoints

  • Direct secure messaging: jason.koelewyn@avera.sdhealthlink.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Royale Meadows Care CenterSioux Center, IA, CCN 165157 Skilled nursing facility Managing Control - Governing Body Jan 1, 2025
Sioux Center Health Home Care and HospiceSioux Center, IA, CCN 161519 Hospice W-2 Managing Employee May 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1659592020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-2609",
            "fax_number": "712-722-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-2609",
            "fax_number": "712-722-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 S Main Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Center",
            "state": "IA",
            "postal_code": "512501347",
            "country_code": "US",
            "telephone_number": "712-722-2609",
            "fax_number": "712-722-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOELEWYN",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "37667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Center, IA

Sources for this page

Verify at the official NPI Registry.