Individual provider Active NPI

Ashlee Kaye Holst, D.O.

  • Internal Medicine Physician
  • Moline, IL
National Provider Identifier
1679892707
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036141459 Issued in IL
Practice address
600 John Deere Rd Ste 200
Moline, IL 61265-6812
Phone
(309) 779-4200
Fax
(309) 779-4305
NPI assigned
May 28, 2010
Last updated
Sep 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4410 IA
Internal Medicine Physician 207R00000X 036141459 IL Primary

Addresses

Primary practice location

600 John Deere Rd Ste 200
Moline, IL 61265-6812

Mailing address

600 John Deere Rd Ste 200
Moline, IL 61265-6812
Phone (309) 779-4200

Other identifiers 4

IdentifierTypeStateIssuer
036141459MedicaidIL
1679892707MedicaidMN
036141459OtherILBLUE SHIELD OF ILLINOIS
1679892707MedicaidIA

Other names 1

  • Ashlee Kaye Bales Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160923000280 IL Practitioner - Internal Medicine 7315181815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians
Medical Arts Associates, LTD.Group PAC ID 4385549377, 19 clinicians

Practice addresses (Care Compare)

300 Tenney St
Kewanee, IL 61443-3452
Phone (309) 853-5500

600 John Deere Rd
Suite 102
Moline, IL 61265-6812
Phone (309) 779-4200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
62.74 of 100Reported as group
Quality
78.19
Promoting interoperability
0
Improvement activities
40
Cost
80.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036141459ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Arts Associates, LTD. Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients

Locations

600 John Deere Rd
Ste 102
Moline, IL 61265
Phone (309) 779-4200

600 John Deere Rd
Ste 200
Moline, IL 61265
Phone (309) 779-4200

Organizations & group practices 1

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 7

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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1679892707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656812",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656812",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLST",
        "first_name": "ASHLEE",
        "middle_name": "KAYE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "4410",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036141459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036141459",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679892707",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "036141459",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679892707",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEE",
            "last_name": "BALES",
            "middle_name": "KAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.