NPIMap

Individual provider Active NPI

Kyle James Glienke, MD

  • Family Medicine Physician
  • Storm Lake, IA
National Provider Identifier
1851633713
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-43865 Issued in IA
Practice address
Unitypoint Clinic-Family Medicine-Buena Vista
620 Northwestern Dr
Storm Lake, IA 50588-2935
Phone
(712) 732-5030
NPI assigned
Mar 19, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 MD-43865 IA Primary
Internal Medicine Physician 207R00000X MD-43865 IA

Addresses

Primary practice location

Unitypoint Clinic-Family Medicine-Buena Vista
620 Northwestern Dr
Storm Lake, IA 50588-2935

Mailing address

PO Box 1455
Des Moines, IA 50306-1455
Phone (515) 471-9300

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
I20170614000088 IA Practitioner - Family PracticePractitioner - Internal Medicine 3173756111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians
Sports Rehab and Professional Therapy Associates IncGroup PAC ID 1658289608, 124 clinicians

Practice addresses (Care Compare)

1525 W 5TH St
Storm Lake, IA 50588-3027
Phone (712) 732-4030

315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-43865IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center CurrentSince May 1, 2018 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Buena Vista Regional Medical Center Past Accepting new patients

Locations

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

620 Northwestern Dr
Storm Lake, IA 50588
Phone (712) 213-8065

620 Northwestern Dr
#C
Storm Lake, IA 50588
Phone (712) 732-5030

620 Northwestern Dr
Ste 1
Storm Lake, IA 50588
Phone (712) 358-1926

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

Interoperability endpoints

  • Direct secure messaging: kglienke9653@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Accura Healthcare of Aurelia LLCAurelia, IA, CCN 165535 Skilled nursing facility W-2 Managing Employee Apr 1, 2024
Unitypoint Clinic Family Medicine - Buena VistaStorm Lake, IA, CCN 168612 Rural health clinic Contracted Managing Employee
Operational/Managerial Control		 Jun 1, 2018
Jun 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 12

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851633713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1455",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503061455",
            "telephone_number": "515-471-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNITYPOINT CLINIC-FAMILY MEDICINE-BUENA VISTA",
            "address_2": "620 NORTHWESTERN DR",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505882935",
            "telephone_number": "712-732-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIENKE",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-43865",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-43865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

Verify at the official NPI Registry.