Individual provider Active NPI

Maksym Puliaiev, M.D.

  • Pulmonary Disease Physician
  • Des Moines, IA
National Provider Identifier
1902210651
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD-47940 Issued in IA
Practice address
411 Laurel St Ste A120
Des Moines, IA 50314-3027
Phone
(515) 643-7900
Fax
(515) 643-7901
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R-11081 IA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X R-11081 IA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD-47940 IA
Pulmonary Disease Physician 207RP1001X R-11081 IA
Pulmonary Disease Physician 207RP1001X MD-47940 IA Primary

Addresses

Primary practice location

411 Laurel St Ste A120
Des Moines, IA 50314-3027

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-7900

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722001770 IA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5799902375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2610

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-4240

1111 6TH Ave E Tower
Des Moines, IA 50314-2610

1755 59TH PL
West Des Moines, IA 50266-7737
Phone (515) 247-4240

2006 N 4TH St
Indianola, IA 50125-4500

204 N 4TH Ave E
Newton, IA 50208-3135

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

411 Laurel St
Des Moines, IA 50314-3027

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-11081IAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc. Critical Care Medicine CurrentSince Aug 1, 2021 Accepting new patients
Catholic Health Initiatives-Iowa Corp Past Accepting new patients

Locations

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

411 Laurel St
Ste 3300
Des Moines, IA 50314
Phone (515) 270-1177

411 Laurel St
Ste A120
Des Moines, IA 50314
Phone (515) 247-3970

300 N 4th Ave E
Ste 222
Newton, IA 50208
Phone (515) 358-0011

Interoperability endpoints

  • Direct secure messaging: mpuliaiev3955155@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1902210651",
    "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": "515-643-7900",
            "fax_number": "515-643-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE A120",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143027",
            "telephone_number": "515-643-7900",
            "fax_number": "515-643-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "52242",
            "country_code": "US",
            "telephone_number": "319-356-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULIAIEV",
        "first_name": "MAKSYM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R-11081",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IA",
            "license": "R-11081",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IA",
            "license": "MD-47940",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IA",
            "license": "R-11081",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IA",
            "license": "MD-47940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.