Active NPI
Mosaic
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
National Provider Identifier
1962554808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- 770990
- Legal business name
- MOSAIC
- Practice address
- 4216 Easton Blvd
Des Moines, IA 50317-0000 - Phone
- (515) 246-1840
- Fax
- (515) 246-8236
- NPI assigned
- Jan 18, 2007
- Last updated
- Jan 18, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Hoffman
- Title
- Senior VP & Chief Financial Officer
- Phone
- (402) 896-3884
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 770990 | IA | Primary |
Addresses
Primary practice location
4216 Easton Blvd
Des Moines, IA 50317-0000
Mailing address
4980 S 118TH St
Omaha, NE 68137-2220
Phone (402) 896-3884
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0881961 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1962554808. Details of each certification follow.
Intermediate care facility for individuals with intellectual disabilities certification: CCN 16G013
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- MOSAIC-EASTON
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Sep 29, 1983
- Last certification
- Jun 26, 2025
- Beds
- 8
- Ownership / control type
- Private (non-profit)
- Most recent change of ownership
- Jul 1, 2003
- Facility address
- 4216 Easton Blvd
Des Moines, IA 50317
National Provider Directory
National Provider Directory- Tax ID family
- Mosaic
Organizations with this tax ID in the same state 15
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
- NPI 1811631369
-
- Mental Illness Community Based Residential Treatment Facility
- Forest City, IA
- NPI 1821616632
-
- Intellectual Disabilities Intermediate Care Facility
- Logan, IA
- NPI 1831246552
-
- Intellectual Disabilities Intermediate Care Facility
- Belmond, IA
- NPI 1831465715
-
- Intellectual Disabilities Intermediate Care Facility
- Nevada, IA
- NPI 1851666820
-
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
- NPI 1881746725
-
- Intellectual Disabilities Intermediate Care Facility
- Pleasant Hill, IA
- NPI 1902540453
-
- Intellectual Disabilities Intermediate Care Facility
- Pleasant Hill, IA
- NPI 1912648411
-
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
- NPI 1922742501
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Osceola, IA
- NPI 1942357546
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Forest City, IA
- NPI 1942575972
-
- Intellectual Disabilities Intermediate Care Facility
- Clarion, IA
- NPI 1952676926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705536000000",
"number": "1962554808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4980 S 118TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372220",
"telephone_number": "402-896-3884",
"fax_number": "402-894-4780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4216 EASTON BLVD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503170000",
"telephone_number": "515-246-1840",
"fax_number": "515-246-8236"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOSAIC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-18",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A",
"authorized_official_last_name": "HOFFMAN",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "SENIOR VP & CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "402-896-3884"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "IA",
"license": "770990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0881961",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.