Individual provider Active NPI

Prudence Kho Dy, M.D.

  • Hospitalist Physician
  • Des Moines, IA
National Provider Identifier
1801278742
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD-44854 Issued in IA
Practice address
1111 6TH Ave
Des Moines, IA 50314
Phone
(515) 247-4240
Fax
(515) 247-4239
NPI assigned
Jun 27, 2015
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X MD-44854 IA Primary

Addresses

Primary practice location

1111 6TH Ave
Des Moines, IA 50314

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 247-4240

Other practice location 1

300 2nd Ave
G417 Monmouth Medical Center
Long Branch, NJ 07740-6303
Phone (732) 923-6540

Other practice location 2

300 2nd Ave
G417 Monmouth Medical Center
Long Branch, NJ 07740-6303
Phone (732) 923-6540

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
I20180125000198 IA Practitioner - HospitalistPractitioner - Internal Medicine 0042579740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 247-4240

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc Hospitalist CurrentSince Sep 1, 2019 Accepting new patients
Mercy Clinics, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Catholic Health Initiatives - Iowa Corp Past Accepting new patients

Locations

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

Interoperability endpoints

  • Direct secure messaging: pdy3943502@direct.trinity-health.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1801278742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-247-4240",
            "fax_number": "515-247-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50314",
            "telephone_number": "515-247-4240",
            "fax_number": "515-247-4239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 2nd Ave",
            "address_2": "G417 Monmouth Medical Center",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-923-6540",
            "fax_number": "732-923-6536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 2nd Ave",
            "address_2": "G417 Monmouth Medical Center",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-923-6540",
            "fax_number": "732-923-6536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DY",
        "first_name": "PRUDENCE",
        "middle_name": "KHO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-27",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-44854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.