Pitayadet Jumrussirikul, M.D.

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

36245 Issued in IA

Practice address

5880 University Ave Ste 112
West Des Moines, IA 50266-8209

Phone

(515) 633-3653

Fax

(515) 280-4630

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Health Initiatives-Iowa CorpGroup PAC ID 5698683142, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083
• Mary Greeley Medical Center Hospital, Ames, IA, CCN 160030
• Mercyone Newton Medical Center Hospital, Newton, IA, CCN 160032
• Pella Regional Health Center Hospital, Pella, IA, CCN 161367
• Wayne County Hospital Hospital, Corydon, IA, CCN 161358

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pjumrussirikul3948720@direct.trinity-health.org
• Direct secure messaging: pitayadet.jumrussirikul.p1@direct.iowaheart.nextgenshare.com

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.

• Catholic Health Initiatives-Iowa Corp

  • Clinical Cardiac Electrophysiology Physician
  • West Des Moines, IA
  • NPI 1629301684

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Catholic Health Initiatives-Iowa Corp

  • Hematology & Oncology Physician
  • Newton, IA
  • NPI 1841039856
  NPD
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)
• Iowa Heart Center PC

  • Cardiovascular Disease Physician
  • West Des Moines, IA
  • NPI 1164410932
  NPD (past)
• Western Slope Cardiology, PC

  • Cardiovascular Disease Physician
  • Grand Junction, CO
  • NPI 1316976442
  NPD (past)

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

• Catholic Health Initiatives - Iowa Corp

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1538395975
  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  • Clinical Medical Laboratory
  • Des Moines, IA
  • NPI 1104982743

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1508964883
  Care Compare affiliation
• Catholic Health Initiatives, Ia-Corp

  • Mammography Clinic/Center
  • Des Moines, IA
  • NPI 1477984367

  Hospital

  Care Compare affiliation
• Mary Greeley Medical Center

  • General Acute Care Hospital
  • Ames, IA
  • NPI 1477539492
  Care Compare affiliation
• Mercy Medical Center-Newton

  • General Acute Care Hospital
  • Newton, IA
  • NPI 1003296179
  Care Compare affiliation
• Pella Regional Health Center

  • Critical Access Hospital
  • Pella, IA
  • NPI 1578520888
  Care Compare affiliation
• Wayne County Hospital

  • Critical Access Hospital
  • Corydon, IA
  • NPI 1174599468
  Care Compare affiliation

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592092800000",
    "number": "1689656605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9170",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503069170",
            "telephone_number": "515-633-3600",
            "fax_number": "515-633-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 UNIVERSITY AVE STE 112",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668209",
            "telephone_number": "515-633-3653",
            "fax_number": "515-280-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMRUSSIRIKUL",
        "first_name": "PITAYADET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "36245",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IA",
            "license": "36245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00261211",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463471",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP NUMBER",
            "identifier": "CD4547",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE NUMBER",
            "identifier": "P00261211",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Cardiac Electrophysiology Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Clinical Cardiac Electrophysiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2020; 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.