Timothy L Evert, DO

Individual provider Active NPI Family Medicine Physician · Des Moines, IA

NPI 1699785477 · NPPES record last updated Jan 29, 2010

Key facts

NPI
1699785477
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
03025 (IA)
Practice address
6601 SW 9TH St
Des Moines, IA 50315-6138
Phone
(515) 643-9400
Fax
(515) 643-9405
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100122000773 IA Practitioner - Emergency Medicine
Practitioner - Family Practice
4385786789 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Hospital Current
since Dec 30, 2012
Accepting new patients
Boone County Hospital Current Accepting new patients
Boone County Hospital Current Accepting new patients
Boone County Hospital Current
since Dec 30, 2012
Accepting new patients

Locations

2605 SW White Birch Dr
Ankeny, IA 50023
Phone (515) 643-7100

1015 Union St
Boone, IA 50036
Phone (515) 432-3140

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 03025 IA Yes

Addresses

Primary practice location

6601 SW 9TH St
Des Moines, IA 50315-6138

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-9400

Other identifiers

IdentifierTypeStateIssuer
3151621MedicaidIA

Other providers in Des Moines, IA

All providers in Des Moines, IA · Family Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.