Individual provider Active NPI

Samuel Dewayne Andrews, M.D.

  • Radiation Oncology Physician
  • Iowa City, IA
National Provider Identifier
1851508337
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
R-7952 Issued in IA
Practice address
200 Hawkins Drive
Iowa City, IA 52242
Phone
(319) 356-2699
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X R-7952 IA Primary
Radiation Oncology Physician 2085R0001X 036-126674 IL

Addresses

Primary practice location

200 Hawkins Drive
Iowa City, IA 52242

Mailing address

200 Hawkins Drive
Iowa City, IA 52242
Phone (319) 356-2699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101108000717 IL Practitioner - Radiation Oncology 5496940181 Reassigns benefits to 2 organizations
I20170112000946 IA Practitioner - Radiation Oncology 5496940181 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-7952IAMDRadiation Oncology Physician
036-126674ILMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Regional Hospital and Nursing Home Radiation Oncology CurrentSince May 20, 2024 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2018 Accepting new patients
Proctor Health Systems CurrentSince Jul 1, 2018 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Proctor Health Systems CurrentSince Jul 1, 2018 Accepting new patients
St Anthony Regional Hospital and Nursing Home CurrentSince May 20, 2024 Accepting new patients
Proctor Health Systems Current Accepting new patients

Locations

311 S Clark St
Carroll, IA 51401
Phone (712) 792-3581

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

815 Main St
Ste A1
Peoria, IL 61602

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1851508337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DRIVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-356-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DRIVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-356-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "SAMUEL",
        "middle_name": "DEWAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IA",
            "license": "R-7952",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036-126674",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.