Individual provider Active NPI

Prince Basoah, MD

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1831035286
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-13765 Issued in IA
Practice address
1111 6TH Ave
Des Moines, IA 50314-2613
Phone
(515) 612-9595
Fax
(515) 346-6721
NPI assigned
Apr 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-13765 IA Primary

Addresses

Primary practice location

1111 6TH Ave
Des Moines, IA 50314-2613

Mailing address

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 612-9595

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
I20260626000647 IA Order and Referring Only - Family PracticePractitioner - Family Practice 2860965217

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1831035286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142613",
            "telephone_number": "515-612-9595",
            "fax_number": "515-346-6721"
        },
        {
            "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": "503142613",
            "telephone_number": "515-612-9595",
            "fax_number": "515-346-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASOAH",
        "first_name": "PRINCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-13765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.