Individual provider Active NPI

Amy Moberg, M.D.

  • Pediatrics Physician
  • Des Moines, IA
National Provider Identifier
1700012986
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R-8654 Issued in IA
Practice address
1200 Pleasant St
Des Moines, IA 50309-1406
Phone
(515) 241-5008
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R-8654 IA Primary

Addresses

Primary practice location

1200 Pleasant St
Des Moines, IA 50309-1406

Mailing address

1200 Pleasant St
Des Moines, IA 50309-1406

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120824000330 IA Practitioner - Pediatric Medicine 5496902504 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-8654IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation Current Accepting new patients
Trinity Regional Medical Center CurrentSince Aug 1, 2020 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Central Iowa Hospital Corporation Pediatrics CurrentSince Jul 1, 2012 Accepting new patients
Central Iowa Hospital Corporation CurrentSince Jul 1, 2012 Accepting new patients
Central Iowa Hospital Corporation Past Accepting new patients
Central Iowa Hospital Corporation Past Accepting new patients

Locations

1200 Pleasant St
Rm 236
Des Moines, IA 50309
Phone (515) 241-6228

1200 Pleasant St
Ste S228
Des Moines, IA 50309

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

1660 60th St
West Des Moines, IA 50266
Phone (515) 241-2250

Interoperability endpoints

  • Direct secure messaging: amoberg9832@direct.unitypoint.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1700012986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBERG",
        "first_name": "AMY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R-8654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.