Mara Renae Kozisek, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

134822 Issued in IA

Practice address

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Phone

(515) 573-3101

NPI assigned

Apr 2, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Regional Medical Center Hospital, Fort Dodge, IA, CCN 160016

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Trinity Regional Medical Center

  dba UnityPoint Clinic

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  Medicare reassignment Care Compare group NPD

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

• Trinity Regional Medical Center

  dba UnityPoint Health Trinity Regional Medical Center

  • General Acute Care Hospital
  • Fort Dodge, IA
  • NPI 1487759858
  Care Compare affiliation

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1669276218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 DODGER DR UNIT 2",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505016346",
            "telephone_number": "641-512-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-573-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZISEK",
        "first_name": "MARA",
        "middle_name": "RENAE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "134822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joette Lynn Kofoot, LMSW
• Tina Koller
• Angela Michelle Koster, LAPC
• Jessica Christine Koval
• Tierney Kozal, ARNP
• Amanda Jean Kuchenreuther, ARNP
• Kyle Ver Steeg MD PC
• Jeff Allan Lachelt, PHARM D
• Debra K Ladd, N.P.
• Alexis Miranda Laing

• Physician Assistant in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.