NPIMap

Organization Active NPI

Iowa Dermatology Clinic PLC

  • Dermatology Physician
  • Marshalltown, IA
National Provider Identifier
1982942702
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
IOWA DERMATOLOGY CLINIC PLC
Practice address
26 S 1St Ave
Suite 100
Marshalltown, IA 50158-5032
Phone
(641) 753-2150
Fax
(641) 753-2509
NPI assigned
Jan 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Authorized official

Name
Andrew B Karas, MBA
Title
Cfo
Phone
51522631116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

26 S 1St Ave
Suite 100
Marshalltown, IA 50158-5032

Mailing address

6000 University Ave
Suite 350
West Des Moines, IA 50266-8203
Phone (515) 226-3116

Other names 1

  • Radiant Complexions Dermatology Clinics or Radiant Pathology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000335 IA Part B Supplier - Clinic/Group Practice 2961394713 Receives reassigned benefits from 25 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marshalltown, IA; Cedar Rapids, IA; Mason City, IA; Norwalk, IA; Storm Lake, IA; Urbandale, IA; West Des Moines, IA; Grinnell, IA…

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1982942702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE",
            "address_2": "SUITE 350",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668203",
            "telephone_number": "515-226-3116",
            "fax_number": "515-391-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S 1ST AVE",
            "address_2": "SUITE 100",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501585032",
            "telephone_number": "641-753-2150",
            "fax_number": "641-753-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA DERMATOLOGY CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "KARAS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "51522631116",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Complexions Dermatology Clinics or Radiant Pathology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.