NPIMap

Individual provider Active NPI

Dominick C Ervelli, D.O.

  • Internal Medicine Physician
  • Ankeny, IA
National Provider Identifier
1871572990
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO-03258 Issued in IA
Practice address
800 E 1St St Ste 1700
Ankeny, IA 50021-2100
Phone
(515) 643-8100
Fax
(515) 643-8139
NPI assigned
Jan 17, 2006
Last updated
May 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 03258 IA
Internal Medicine Physician 207R00000X DO-03258 IA Primary

Addresses

Primary practice location

800 E 1St St Ste 1700
Ankeny, IA 50021-2100

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-8100

Other practice location 1

235 Highway 30 W
Westside, IA 51467-7585
Phone (712) 663-4371

Other identifiers 1

IdentifierTypeStateIssuer
1196071MedicaidIA

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
I20100817000045 IA Practitioner - Internal Medicine 7315071156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

800 E 1St St
1700 Mercyone Ankeny Family Medicine Clinic
Ankeny, IA 50021-2100
Phone (515) 643-8100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03258IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc CurrentSince May 1, 2022 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc. CurrentSince May 1, 2022 Accepting new patients

Locations

800 E 1st St
Ste 1700
Ankeny, IA 50021
Phone (515) 643-8100

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

Interoperability endpoints

  • Direct secure messaging: dervelli3944294@direct.trinity-health.org

Organizations & group practices 3

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 5

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1871572990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-8100",
            "fax_number": "515-643-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 1ST ST STE 1700",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500212100",
            "telephone_number": "515-643-8100",
            "fax_number": "515-643-8139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Highway 30 W",
            "address_purpose": "LOCATION",
            "city": "Westside",
            "state": "IA",
            "postal_code": "514677585",
            "country_code": "US",
            "telephone_number": "712-663-4371",
            "fax_number": "712-663-4370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERVELLI",
        "first_name": "DOMINICK",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "03258",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "DO-03258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1196071",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.