Individual provider Active NPI

Jennifer Ann Daza, PA-C

  • Physician Assistant
  • Urbandale, IA
National Provider Identifier
1841674769
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
078992 Issued in IA
Practice address
2901 86TH St
Urbandale, IA 50322-4204
Phone
(515) 276-3406
Fax
(515) 278-2377
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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 078992 IA Primary

Addresses

Primary practice location

2901 86TH St
Urbandale, IA 50322-4204

Mailing address

2901 86TH St
Urbandale, IA 50322-4204
Phone (515) 276-3406

Other identifiers 1

IdentifierTypeStateIssuer
078992OtherIAIOWA LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728004349 IA Practitioner - Physician Assistant 0143534628 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)

1055 SW Oralabor Rd
Upc Express Care
Ankeny, IA 50023-1280
Phone (515) 965-7661

1152 SE Ashworth Rd
Waukee, IA 50263-8843
Phone (515) 264-2200

180 Jordan Creek Pkwy
Suite 120
West Des Moines, IA 50266-8490
Phone (515) 224-5868

2103 Ingersoll Ave
Des Moines, IA 50312-5227

2720 8TH St SW
Altoona, IA 50009-1028
Phone (515) 967-0133

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

5200 100TH St
Urbandale, IA 50322-7208
Phone (515) 251-3880

6520 SE 14TH St
Des Moines, IA 50320-1846
Phone (515) 953-1500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Feb 19, 2018 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Feb 19, 2018 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Des Moines Orthopaedic Surgeons PC Physician Assistant Past Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

2720 8th St SW
Ste A2
Altoona, IA 50009
Phone (515) 967-0133

1055 SW Oralabor Rd
Ankeny, IA 50023
Phone (515) 371-9406

3625 N Ankeny Blvd
Ste E
Ankeny, IA 50023
Phone (515) 965-4664

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

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

2103 Ingersoll Ave
Ste 2
Des Moines, IA 50312
Phone (515) 323-5680

6520 SE 14th St
Des Moines, IA 50320
Phone (515) 256-4242

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

5200 100th St
Urbandale, IA 50322
Phone (515) 265-4211

2901 86th St
Urbandale, IA 50322
Phone (515) 276-3406

950 E Hickman Rd
Waukee, IA 50263
Phone (515) 987-8256

180 Jordan Creek Pkwy
Ste 120
West Des Moines, IA 50266
Phone (515) 224-5868

6000 University Ave
Ste 101
West Des Moines, IA 50266
Phone (515) 241-2320

Interoperability endpoints

  • Direct secure messaging: jpieper274668@direct.unitypoint.org

Organizations & group practices 5

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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1841674769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 86TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224204",
            "telephone_number": "515-276-3406",
            "fax_number": "515-278-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 86TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224204",
            "telephone_number": "515-276-3406",
            "fax_number": "515-278-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAZA",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "078992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "078992",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.