NPIMap

Individual provider Active NPI

Alexandra Vander Meide, MD

  • Family Medicine Physician
  • Johnston, IA
National Provider Identifier
1811904295
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-38071 Issued in IA
Practice address
5900 NW 86TH St
Ste 100
Johnston, IA 50131-2284
Phone
(515) 276-6133
Fax
(515) 334-7356
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01055415A IN
Family Medicine Physician 207Q00000X MD-38071 IA Primary

Addresses

Primary practice location

5900 NW 86TH St
Ste 100
Johnston, IA 50131-2284

Mailing address

5900 NW 86TH St
Ste 100
Johnston, IA 50131-2284
Phone (515) 276-6133

Other identifiers 2

IdentifierTypeStateIssuer
P00784915OtherIARR MEDICARE
1811904295MedicaidIA

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
I20100118000284 IA Practitioner - Family Practice 8527100296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Suite 2230
Bettendorf, IA 52722-1644
Phone (563) 742-5150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-38071IAMDFamily Medicine Physician
01055415AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Dec 7, 2009 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

5900 NW 86th St
Ste 100
Johnston, IA 50131
Phone (515) 246-6133

Interoperability endpoints

  • Direct secure messaging: avandermeide244690@direct.unitypoint.org

Organizations & group practices 2

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 7

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1811904295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 NW 86TH ST",
            "address_2": "STE 100",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312284",
            "telephone_number": "515-276-6133",
            "fax_number": "515-334-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 NW 86TH ST",
            "address_2": "STE 100",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312284",
            "telephone_number": "515-276-6133",
            "fax_number": "515-334-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER MEIDE",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01055415A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-38071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00784915",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811904295",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.