Individual provider Active NPI

Amy Andersen, MD

  • Family Medicine Physician
  • North Liberty, IA
National Provider Identifier
1932169778
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33637 Issued in IA
Practice address
1765 Lininger LN
North Liberty, IA 52317-2316
Phone
(319) 665-3055
NPI assigned
Mar 24, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Female
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 33637 IA Primary

Addresses

Primary practice location

1765 Lininger LN
North Liberty, IA 52317-2316

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2192823MedicaidIA

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
I20100331000646 IA Practitioner - Family Practice 5395871180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Rehabilitation Associates LLCGroup PAC ID 2961443072, 275 clinicians
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians

Practice addresses (Care Compare)

1130 S Scott Blvd
Suite 1
Iowa City, IA 52240-2909
Phone (319) 354-2429

1765 Lininger LN
Suite 1
North Liberty, IA 52317-2336
Phone (319) 665-3053

300 W May St
Marengo, IA 52301-1261
Phone (319) 642-5543

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
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

State licenses

LicenseStateTypeSpecialty
33637IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Associates, Inc Family Medicine CurrentSince Mar 15, 2012 Accepting new patients
Mercy Care Management, Inc Family Medicine CurrentSince Jun 1, 2013 Accepting new patients
Mercy Physician Associates, Inc Family Medicine Current Accepting new patients
Mercy Care Management, Inc Family Medicine CurrentSince Jun 1, 2013 Accepting new patients
Mercy Physician Associates Inc Family Medicine CurrentSince Mar 15, 2012 Accepting new patients
Mercy Medical Center Past Accepting new patients
Mercy Physician Associates, Inc Family Medicine Past Accepting new patients

Locations

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

75 Short St NW
Cedar Rapids, IA 52405
Phone (319) 396-3395

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

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

1765 Lininger Ln
North Liberty, IA 52317
Phone (319) 467-7888

1765 Lininger Ln
Ste 1
North Liberty, IA 52317
Phone (319) 665-3053

Organizations & group practices 8

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 3

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1932169778",
    "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": "1765 LININGER LN",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523172316",
            "telephone_number": "319-665-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "AMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2192823",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.