NPIMap

Individual provider Active NPI

Stewart Douglas Kanis, DO

  • Internal Medicine Physician
  • Pella, IA
National Provider Identifier
1689787152
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3671 Issued in IA
Practice address
405 Monroe St
Pella, IA 50219-1189
Phone
(641) 628-3832
Fax
(641) 628-8894
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3671 IA Primary

Addresses

Primary practice location

405 Monroe St
Pella, IA 50219-1189

Mailing address

405 Monroe Street
Pella, IA 50219
Phone (641) 621-2200

Other identifiers 2

IdentifierTypeStateIssuer
1689787152OtherIANPI
0794982MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prhc@direct.pellahealth.kobledirect.com Direct

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
I20070806000370 IA Practitioner - Internal Medicine 5395836381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pella Regional Health Center 96 clinicians

Practice addresses (Care Compare)

404 Jefferson St
Pella, IA 50219-1257

405 Monroe St
Pella, IA 50219-1189
Phone (641) 628-3832

405 Monroe St
Pella, IA 50219-1290

411 Merrill St
Bussey, IA 50044-7711
Phone (641) 944-5813

920 N Quincy Ave
Ottumwa Medical Clinic
Ottumwa, IA 52501-3866
Phone (641) 455-5200

Hospital & facility affiliations

  • Pella Regional Home Health Agency Home health agency, Pella, IA, CCN 167220
  • Wesleylife Hospice Hospice, Urbandale, IA, CCN 161587
  • Hospice of Pella, the Comfort House Hospice, Pella, IA, CCN 161538
  • Pella Regional Health Center Hospital, Pella, IA, CCN 161367
  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083
  • The Cottages Nursing home, Pella, IA, CCN 165607

Merit-based Incentive Payment System (MIPS)

Final score
91.84 of 100Reported as group
Quality
91.13
Promoting interoperability
100
Improvement activities
40
Cost
81.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3671IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pella Regional Health Center CurrentSince Aug 1, 2007 Accepting new patients
Pella Regional Health Center Internal Medicine CurrentSince Aug 1, 2007 Accepting new patients
Pella Regional Health Center Current Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

405 Monroe St
Pella, IA 50219
Phone (641) 621-2200

Organizations & group practices 11

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 9

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1689787152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MONROE STREET",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "50219",
            "telephone_number": "641-621-2200",
            "fax_number": "641-621-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-628-3832",
            "fax_number": "641-628-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANIS",
        "first_name": "STEWART",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "3671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689787152",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0794982",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prhc@direct.pellahealth.kobledirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "405 Monroe St",
            "city": "Pella",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502191189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.