Individual provider Active NPI

Priscilla M. Putzier, D.O.

  • Pediatrics Physician
  • Des Moines, IA
National Provider Identifier
1962638031
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4290 Issued in IA
Practice address
1200 Pleasant St
Des Moines, IA 50309-1406
Phone
(515) 241-5926
Fax
(515) 241-5127
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-7500 AR
Pediatrics Physician 208000000X 4290 IA Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X E-7500 AR

Addresses

Primary practice location

1200 Pleasant St
Des Moines, IA 50309-1406

Mailing address

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-5926

Other identifiers 1

IdentifierTypeStateIssuer
1962638031MedicaidIA

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
I20150810000608 IA Practitioner - Pediatric Medicine 4587891122 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4290IAMDPediatrics Physician
E-7500ARMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Jul 1, 2015 Accepting new patients
Central Iowa Hospital Corporation Current Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Central Iowa Hospital Corporation CurrentSince Jul 1, 2015 Accepting new patients

Locations

1200 Pleasant St
Ste S228
Des Moines, IA 50309

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

Interoperability endpoints

  • Direct secure messaging: pputzier15579@direct.unitypoint.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1962638031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5926",
            "fax_number": "515-241-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5926",
            "fax_number": "515-241-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTZIER",
        "first_name": "PRISCILLA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-7500",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "4290",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "AR",
            "license": "E-7500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962638031",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.