NPIMap

Individual provider Active NPI

Jason Booth, MD

  • Family Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1861460495
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33657 Issued in IA
Practice address
3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869
Phone
(319) 363-8148
Fax
(319) 363-9118
NPI assigned
Mar 9, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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 33657 IA Primary

Addresses

Primary practice location

3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505

Other identifiers 1

IdentifierTypeStateIssuer
0228692MedicaidIA

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
I20100513000814 IA Practitioner - Family Practice 1254469133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians

Practice addresses (Care Compare)

1790 Blairs Ferry Rd
Hiawatha, IA 52233-2033
Phone (319) 378-8362

310 Hwy 1 SE
Mt Vernon, IA 52314-9501
Phone (319) 895-9010

3701 Katz Dr
Marion, IA 52302-3871
Phone (319) 377-3174

3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869
Phone (319) 363-9118

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Associates, Inc Family Medicine CurrentSince Feb 20, 2003 Accepting new patients
Mercy Physician Associates, Inc Family Medicine Current Accepting new patients
Mercy Physician Associates Inc Family Medicine CurrentSince Feb 20, 2003 Accepting new patients
Mercy Physician Associates, Inc Family Medicine Past Accepting new patients
Mercy Care Management, Inc Family Medicine Past Accepting new patients
Mercy Care Management, Inc Family Medicine Past Accepting new patients

Locations

3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403
Phone (319) 363-8148

5264 Council St NE
Ste 100
Cedar Rapids, IA 52402
Phone (319) 221-8444

1790 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 378-8362

300 W May St
Marengo, IA 52301
Phone (319) 462-8011

Organizations & group practices 6

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 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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1861460495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 MOUNT VERNON RD SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524033869",
            "telephone_number": "319-363-8148",
            "fax_number": "319-363-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0228692",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.