NPIMap

Individual provider Active NPI

Megan R Grodahl, P.A.

  • Physician Assistant
  • Lake City, IA
National Provider Identifier
1801264825
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
079586 Issued in IA
Practice address
1351 W Main St
Lake City, IA 51449-1585
Phone
(712) 464-7907
Fax
(712) 464-7412
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 079586 IA Primary

Addresses

Primary practice location

1351 W Main St
Lake City, IA 51449-1585

Mailing address

1301 W Main St
PO Box 114
Lake City, IA 51449-1585
Phone (712) 464-3171

Other names 1

  • Megan R Dollen Former name

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
I20151009001344 IA Practitioner - Physician Assistant 0648588715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 W Main St
Lake City, IA 51449-1585
Phone (712) 464-3171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.59 of 100Reported as group
Quality
90
Promoting interoperability
84
Improvement activities
40
Cost
71.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stewart Memorial Community Hospital CurrentSince Sep 14, 2015 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Stewart Memorial Community Hospital Physician Assistant Past Accepting new patients

Locations

1301 W Main St
Lake City, IA 51449
Phone (712) 464-3171

1301 W Main St
#114
Lake City, IA 51449

1351 W Main St
Lake City, IA 51449
Phone (712) 464-7907

Interoperability endpoints

  • Direct secure messaging: mgrodahl299804@direct.unitypoint.org

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.

Hospital & facility affiliations 4

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1801264825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W MAIN ST",
            "address_2": "PO BOX 114",
            "city": "LAKE CITY",
            "state": "IA",
            "postal_code": "514491585",
            "telephone_number": "712-464-3171",
            "fax_number": "712-464-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 W MAIN ST",
            "city": "LAKE CITY",
            "state": "IA",
            "postal_code": "514491585",
            "telephone_number": "712-464-7907",
            "fax_number": "712-464-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODAHL",
        "first_name": "MEGAN",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "079586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "DOLLEN",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake City, IA

Sources for this page

Verify at the official NPI Registry.